Position Objective: The Admissions Review Coordinator is responsible for providing streamlined and patient-centered inpatient and observation admissions processes that support accurate data collection, complete regulatory record documentation, and comprehensive benefits coordination. Through this work, the ARC will ensure a positive patient experience and seamless back-end processing. Essential Job Duties: 1) Conducts direct patient interviews for all incoming patients being directly admitted and/or placed in observation; Confirming/entering and/or troubleshooting all demographic and insurance information; Explains admission paperwork, including state-and-federally required notices and obtaining signatures on all required documents.2) Processes and updates admission-related information in the system including, but not limited to, Spiritual Care and Visit Contact data for patients transferring into higher levels of care. Reviews for and ensures completion of all other required paperwork.3) Investigates for appropriate representation when the patient is unable to understand and/or sign required documentation, such as state and federally required notices and/or consent to treat forms. Obtains verbal approval and documents as such, when necessary. Escalates concerns for guardianship when no representative can be secured.4) Reviews admissions daily to ensure the accuracy of coverage information and COB. Ensures appropriate coverage is applied to patient hospital account timely by obtaining verification via RTE, payor portal, or phone. Verifies medical benefits are in place and appropriately filed on the hospital account. Communicates late updates to Care Management and PAVE staff to ensure proper authorization and UR processes are followed.5) Processes all Labor and Delivery pre-registration information, and schedules inductions, and other triage appointments promptly. Communicates with OB offices to coordinate patient-scheduled visits. Registers all Labor and Delivery patients within one day of delivery. Educates patients on adding newborn children to their existing medical coverage.6) Processes all requests for registration corrections when received. Assists in registration accuracy data collection and reporting by finding, correcting, and reporting incorrect information monthly to the Manager of Patient Access.7) Secures payments by screening insurance information and identifying copayments for admissions and observation. Attempts to collect patient cost-sharing amounts and outstanding balances/bad debt. Discusses financial counseling and assistance options, when appropriate. Refers patient accounts to financial counselors when further explanation/education is needed regarding denied authorizations, out-of-pocket liabilities, coverage options, payment plans, estimates, etc.8) Monitors assigned work queues and follows up directly with medical providers to correct or update order entries to avoid denials related to denied days and missed authorizations. Corrects discharge entry errors. Ensures all account corrections are resolved while a patient is admitted whenever possible.9) Communicates and interacts with others in a professional, responsible, cooperative, and positive manner at all times. Maintains empathy and professionalism in registration interviews and while providing regulatory information and notices.10) Attends departmental staff meetings when scheduled or watches videos when absent. Attends all required in-person training/in-services and completes monthly refreshers. Adheres to the hospital policies and procedures (i.e. timely arrival, minimal absences, appropriate attire, readiness for work, personal electronic usage, and all other policies outlined by the organization).11) Performs other duties as assigned by the Director, Manager, or Supervisor. Educational/Experience Requirements:
- High School Diploma
- Ability to work independently
- Good oral and written communication to work with various patients, families, and departments
- 1-3 years of customer service, administrative, and/or data entry experience required.
- 1-2 years experience in a healthcare environment, highly preferred
Required License/Certifications:
- CPAS within 6 months.
- CPFSS within one year
Working Conditions, Equipment, Physical Demands: There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.Physical Demands - Light Work - Exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.