Admissions Specialist - Call Center (Turnos Rotativos)

San Juan Capestrano•Río Piedras, PR

About The Position

Clinical professional responsible for inquiries, assessments, and admissions to the facility. This role facilitates admissions and assessment processes for incoming patients, responds to inquiries about the facility, and schedules and completes pre-admission assessments. The specialist collaborates with medical and psychiatric personnel to ensure appropriate recommendations and admissions, coordinates admission and transfer between levels of care, and communicates projected admissions promptly. A key responsibility includes performing insurance benefit verifications and ensuring all medical admission documentation is gathered from external sources. The role also involves assisting therapists with concurrent reviews, coordinating peer-to-peer reviews, and providing ongoing assessment of patient status. A positive, empathetic, and professional attitude is essential, with a focus on resolving complaints and prioritizing patient safety. The specialist is also responsible for conducting safety checks and ensuring supervision at specified intervals.

Requirements

Bachelor’s degree in Behavioral Science, Social Services Field, may also be an RN registered nurse, in which case, an Associate's degree in nursing may be the minimum educational requirement or a licensed practical or vocational nurse, in which case, successful completion of an LPN or LVN training program may be the minimum requirement.
CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).
First aid may be required based on state or facility.

Nice To Haves

For states in which a therapist may act in this role, a master's degree in a therapeutic field is preferred.
One or more years’ experience working with individuals in a clinical or observational capacity within the area of specialty for the facility preferred.
Licensure, as preferred for the area of clinical specialty as designated by the state in which the facility operates.

Responsibilities

Facilitate admissions and assessment processes for incoming patients.
Respond to inquiries about the facility within facility policy timeframes.
Schedule and complete pre-admission assessments and communicate recommendations to patients or their families.
Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations and admissions.
Coordinate admission and transfer between levels of care within the facility.
Communicate projected admissions to designated internal representatives promptly.
Perform insurance benefit verifications, disseminating the information gathered to the patient, their families, and other appropriate facility staff.
Ensure all medical admission documentation is gathered from external sources prior to patient admission and secure initial pre-authorization for treatment and admission.
Assist individual therapists with concurrent reviews with insurance companies to secure continued treatment.
Coordinate and facilitate peer-to-peer reviews when needed and collaborate the results of reviews with the multi-disciplinary treatment team.
Provide accurate and ongoing assessment of patient status in the admissions process.
Communicate treatment recommendations to other treatment teams.
Demonstrate a positive, empathetic, and professional attitude toward customers always.
When patient needs are not met, acknowledge and work to resolve complaints.
Recognize that patient safety is a top priority.
Demonstrate a sense of urgency related to the importance of patient safety and provide excellent customer service.
Responsible for conducting safety checks and ensuring that supervision is conducted at 15-minute intervals, as noted in special precautions, or in accordance with individualized supervision guidelines as needed.
Perform other functions and tasks as assigned.