Admissions Manager

BrightSpring Health Services•Pleasanton, CA

7d•$29 - $34

About The Position

As the Admissions Manager, you will be the primary point of contact for individuals recovering from brain injuries, spinal cord injuries, and other complex conditions . Your expertise in navigating benefits, payers, and care coordination will help ensure that patients receive the services they need efficiently, accurately, and with exceptional care.

Requirements

Bachelor’s Degree in Nursing or health care field. Related admissions and medical insurance work experience of at least 5 years will be considered in place of degree.
Minimum of 3-years’ experience working in rehabilitation or healthcare setting
Strong knowledge of rehabilitation operations and third-party payer reimbursement
Proficient data entry and computer skills including Microsoft Word and Excel
Excellent negotiation, organization, problem-solving, decision making and communication skills also required.
Able to function in position with minimal supervision
Effective and professional interpersonal, verbal, and written communication skills

Responsibilities

Receives/responds to incoming calls from referral sources/potential clients and exchanges information to identify the clients' needs and consults with Director of Clinical Management to determine the Company's ability to meet them.
Completes all viable referrals by setting up and carrying out pre-screening assessments, completion of pre-screening reports, preparation of case proposals and other related pre-admission paperwork (i.e., obtains authorization for payment, coordinates availability of an appropriate treatment team).
Oversees, directs and supervises field staff assigned in assisting with pre-screening process.
Accesses national/state/company account information, including the account names and terms of contracts or other past payer agreements, as appropriate.
Consults with third party representatives regarding client benefit coverage, client financial responsibility, company service authorization and specific reimbursement procedures. Presents company’s services, interprets potential reimbursement options, and negotiates reimbursement levels with third party payer.
Contacts referral sources to advise them of case acceptance and provides information on the clinical team responsible for client's case.
Develops/maintains a working knowledge of all services/resources provided by the Company and services available within the community. Assists in identifying alternative community service sources when company solutions are not appropriate or available.
Maintains relationships with standard referral sources and payer case managers. Contacts identified referral sources and seeks referrals as appropriate. Records outcome of calls and keeps the SAR informed. May assist CRM in other sales/marketing activities.
Monitors/tracks referral sources' satisfaction levels, tracks/reports on conversion ratios and provides summary reports to management at requested intervals.
Participates in performance improvement activities. Ensures the collection of data for improvement analysis and prepares reports for management, as needed.
Implements/maintains, with the up-line management, operational processes to ensure compliance with Company policies, legal requirements and regulatory mandates.
Adheres to and participates in Company’s mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices.
Participates in quarterly growth planning meetings/activities including discussions around staffing and recruitment needs.
Performs all duties inherent in a supervisory role for any direct reports.
Participates in special projects and performs other duties as assigned.