Admission Specialist (47037)

WESTCARE INC•Milwaukee, WI

15d•$21 - $21•Onsite

About The Position

Person in this position is responsible for coordinating the inpatient admissions process including insurance pre-authorization for admission. Preferred candidate to have experience working with health insurance companies, performing account set-up & management, have medical terminology knowledge, possess excellent computer skills and be detail oriented. Experience in Behavioral Health setting is also preferred. Essential Job Functions: Meets with each new client on admission and accurately inputs all necessary financial and/or insurance information into agency database. Verifies insurance by checking enrollment and funding status in multiple databases and documents insurance benefits in admission database prior to admission. Facilitates completion of any client information, financial payments, authorizations or other documentation at the time of admission. Calculates copayments and/or private fees and provides an invoice to client prior to discharge. Maintain proper balance regarding source of payment (fee for service, Medicaid, public, private, and third-party payers) Responsible for educating clients on benefits and opportunities within the WestCare system. Resolves any issues with coverage and escalates complicated issues to the billing manager and/or director. Coordinate with the billing manager to assure all admissions/transfers/discharges are completed within the appropriate time frame. Work collaboratively with treatment teams of all programs, communicating information needed to maximize good customer service to clients, referral sources and third party payers. Maintain daily census and provide census information to internal and external sources on a timely basis. Assist all clients with application process for Medicaid by assisting with completion of the application, addressing any questions or concerns and helping the client to find the most appropriate coverage option available. Relay reporting information to billing manager regarding non-insured clients, daily. Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position. Embrace and embody the mission, vision, guiding principles, clinical vision and goals of WestCare Foundation; and Perform any other duties as assigned.

Requirements

HIV/AIDS 104 Basic Education and valid CPR Certificates are required. 20 hours of continuing education required annually.
High School Diploma or equivalent is required
Maintains confidential files and records
Working knowledge of behavioral health terminology
Admissions and insurance verification experience, preferred
Proficiency in Microsoft Office Platform Applications and knowledge of HIPAA regulations and guidelines.
Knowledge of managed care and reimbursement principles.
Understanding and proficiency in MCO & State Medicaid Chapter requirements
Collaboration, negotiation, and assertiveness skills.
Must be organized, detail oriented and have the ability to focus on several job-specific tasks with several potential surrounding distractions and patient traffic.
Excellent verbal and written communication skills.
Critical thinking and problem solving skills.
Must be able to work in a team environment.
Ability to perform complex tasks and to prioritize multiple projects.
Strong analytical and critical thinking skills and the ability to analyze, summarize, and effectively present data.
Ability to work collaboratively with others in a manner that is pleasant and professional.
Ability to exercise good judgment and discretion.
Ability to operate a computer and complete documents in Microsoft program formats.
Ability to complete work tasks within scheduled work hours.
Excellent verbal and written communication skills.
Knowledge of WestCare Mission, goals and values
Knowledge of Incident Reporting
Knowledge of HIPAA, Professional Ethics, Consumer Rights and Confidentiality
Familiarity with WestCare services and programs
Understanding of issues related to cultural identity, ethnic background, age, developmental level, gender and sexual orientation in prevention, intervention and treatment.
Demonstrates ability to work effectively with culturally diverse staff and consumers
Demonstrates respect for an individual’s cultural and ethnic values when interacting with them
Articulates a working definition of trauma
Understands the impact of trauma
Understands re-traumatization
Demonstrates a high degree of dependability.
Maintains a good attendance record.
Observes working hours
Shows flexibility and is responsive to requests from supervisor
Works independently with minimal supervision
Exhibits characteristics of good workmanship, and integrity on the job
Work time is always productive
Demonstrates ability to establish and maintain effective working relationships with consumers, co-workers, external partners, and regulatory agencies
Is courteous to consumers, staff, and all others.
Demonstrates tact at the appropriate time.
Cooperates with others both within and outside WestCare.
Works well with supervisor; accepts direction and supervision
Maintains a positive attitude toward work
Ensures and maintains a safe working environment.
Work area is clean and orderly.
Verbalizes, understands and adheres to agency safety procedures.
Demonstrates appropriate use of Unusual Incident Reports, in accordance with the Center’s reporting procedures
Presents a positive personal image
Dresses and maintains a professional demeanor
Excellent communication skills
Ability to exercise good judgment and discretion
Ability to work well in a team environment
Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality
CPR Certification, First Aid Certification and an annual Tuberculosis test.
Ability to provide an Affidavit of Good Moral Character
Clearance in Pre-Employment Drug Testing and Criminal Records Checks, as required.

Nice To Haves

Preferred candidate to have experience working with health insurance companies, performing account set-up & management, have medical terminology knowledge, possess excellent computer skills and be detail oriented.
Experience in Behavioral Health setting is also preferred.
Graduation from an accredited two-year college with an associates degree is preferre
2 years admission review experience preferred.
Previous experience in Medicaid/Managed Care preferred
Admissions and insurance verification experience, preferred

Responsibilities

Meets with each new client on admission and accurately inputs all necessary financial and/or insurance information into agency database.
Verifies insurance by checking enrollment and funding status in multiple databases and documents insurance benefits in admission database prior to admission.
Facilitates completion of any client information, financial payments, authorizations or other documentation at the time of admission.
Calculates copayments and/or private fees and provides an invoice to client prior to discharge.
Maintain proper balance regarding source of payment (fee for service, Medicaid, public, private, and third-party payers)
Responsible for educating clients on benefits and opportunities within the WestCare system.
Resolves any issues with coverage and escalates complicated issues to the billing manager and/or director.
Coordinate with the billing manager to assure all admissions/transfers/discharges are completed within the appropriate time frame.
Work collaboratively with treatment teams of all programs, communicating information needed to maximize good customer service to clients, referral sources and third party payers.
Maintain daily census and provide census information to internal and external sources on a timely basis.
Assist all clients with application process for Medicaid by assisting with completion of the application, addressing any questions or concerns and helping the client to find the most appropriate coverage option available.
Relay reporting information to billing manager regarding non-insured clients, daily.
Completes all orientation and mandated training activities, including E-Learning Courses, within required timeframes, and in accordance with the criteria established for this position.
Embrace and embody the mission, vision, guiding principles, clinical vision and goals of WestCare Foundation
Perform any other duties as assigned.