Clinical Assessment Specialist
About The Position
The Clinical Assessment Specialist is an integral member of the hospital business development team and facilitates patient admissions to the rehabilitation hospital by assisting field clinical liaisons with preadmission screening (PAS) completion and pull-through. This is an on-site position at the hospital; remote work is not available, and candidates must be able to commute to the location. The specialist reviews medical records and patient history, assesses eligibility and suitability for rehabilitation services, and completes detailed, timely preadmission assessments that meet regulatory requirements and document medical necessity and projected rehabilitation needs. The role also coordinates insurance authorization, maintains relationships with payor case managers and medical directors, and contributes market intelligence and admission strategies to the team. The posted salary range is $70,000–$95,000 per year, depending on experience. The schedule is Monday through Friday, 8 AM to 5 PM.
Requirements
- Demonstrated computer proficiency.
- Sound judgment when handling confidential healthcare information.
Nice To Haves
- Current and valid state licensure or eligibility for state licensure as a Registered Nurse or Respiratory Therapist.
- Two years of related experience in a clinical healthcare setting role.
- Demonstrated competency with the preadmission process, including assessments, transitions-of-care communication, and patient pull-through.
- Previous experience in a hospital setting.
Responsibilities
- Work with the Admission Department and/or acute care hospital personnel to secure insurance authorization or coordinate benefits needed for admission.
- Develop professional relationships with insurance case managers as appropriate.
- Assess patient eligibility for and feasibility of rehabilitation services in consultation with field Clinical Liaisons, the Senior Clinical Liaison, or the Director of Business Development.
- Review and analyze medical records and history relevant to determining suitability for rehabilitation services.
- Prepare and complete detailed preadmission assessments promptly and thoroughly, meeting regulatory requirements.
- Document critical thinking and the rationale for admission, including medical necessity and projected rehabilitation needs.
- Participate in meetings with hospital leadership, the Director of Business Development, and clinical liaisons to provide market intelligence and share strategies and results.
- Support team members in the field or admissions office as appropriate.
- Provide backup assistance with insurance authorization as needed.
- Obtain timely authorization for patients requiring pre-certification and be accountable for conversion percentage and results.
- Follow policies governing commercial pre-certification and authorization to minimize financial risk.
- Maintain payor relationship profiles for payor case managers and medical directors.
- Identify payor preferences or use best-practice coversheets and submission portfolios to maximize results with insurance companies.
- Develop and maintain professional credibility, mutual respect, and confidence with leadership and teammates.
- Perform other related projects and duties as assigned.
Benefits
- Extensive orientation program.
- Generous paid time off.
- Medical, prescription, health, vision, and dental plan offerings.
- Company-matching 401(k) retirement plan.
- Life and disability protection.
- Company-paid parking.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
