Admissions Coordinator

2 weeks ago

Pensacola, Florida, United States Peoples Home Health LLC Full time

Position Overview:

The Admissions Coordinator plays a vital role in managing the intake process by distributing admission information in accordance with company protocols. This includes prioritizing incoming calls, ensuring the availability of admission packets, and interpreting insurance policy benefits to accurately reflect coverage amounts and client co-payments (pending prior authorization).

This position requires the ability to communicate and relay essential clinical information to secure authorization for Home Care Services.

Additionally, the Admissions Coordinator is responsible for precise data entry of referral information into the Home Care Management System (HCMS).

Demonstrating the company’s Mission, Vision, and Guiding Principles through daily behavior and job performance is essential.


Key Responsibilities:


1. Accurately inputs all demographic, financial, and referral data into the computer systems to facilitate timely billing and scheduling.

2. Manages phone communications and appropriately directs referral calls based on clinical requirements.
3. Prioritizes follow-up calls, including those from healthcare providers and insurance companies.
4. Supports the Intake Supervisor by preparing client referrals for clinical review in line with company policies, state and federal regulations, and private insurance agreements.
5. Effectively prioritizes referrals to address the most urgent needs first, collaborating with Case Managers, schedulers, and referral sources to coordinate admission dates and times.
6. Calculates co-pays and deductible amounts in accordance with insurance reimbursement policies.
7. Completes all necessary documentation for initial authorization as per insurance contracts and follows up on authorization requests as needed, informing staff of received authorizations and visit limits, as well as any need for client discharge due to denial of further authorization.8. Engages in communication and problem resolution regarding insurance interpretations, identifying carriers and verifying benefits and eligibility.
9. Collaborates with Case Managers on authorized visits to ensure accurate utilization based on patient needs.
10. Maintains communication with Liaisons via text or email to ensure timely notification of received referrals and required documentation. Responds to inquiries during weekends and after hours regarding insurance questions for new referrals. Acts as a backup to clinical staff as needed, assisting with tasks such as copying and faxing.
11. Strives to create a positive experience for customers, ensuring they feel valued and appreciated. Maintains a comprehensive understanding of the company’s services.
12. Understands the organizational structure and effectively transfers calls within the company. Upholds a professional demeanor and utilizes appropriate phone etiquette.
13. Fosters a welcoming environment for all visitors while ensuring patient confidentiality at all times. Participates in the accreditation program.
14. Assists referral sources in finding placements for patients that cannot be accepted due to insurance constraints. Communicates all outstanding referrals and details to the evening/weekend intake supervisor via phone or email. Maintains a daily referral report and distributes it to assigned staff. Performs additional duties as assigned.

Work Environment:
Office setting. Potential exposure to biological hazards.

Qualifications:
Preferred: Associate's degree; Required: High School diploma (or equivalent). A minimum of three (3) years of experience in a medical environment or medical office is preferred. Familiarity with billing, insurance reimbursement, medical terminology, and diagnosis coding is advantageous. Experience in troubleshooting computer issues, maintaining records, and organizational skills is preferred. Proficiency in Microsoft Word and Excel is required. Ability to prioritize tasks, manage time effectively, and make independent decisions when necessary.

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