Clinical Referral Coordinator

Under the supervision of the Director of Referral Management, assumes responsibility for review of referrals and coordination of clinically and financially appropriate admissions.
Conducts clinical review of referral documents to determine appropriateness for admission including review of current medical needs, equipment needs and medication lists.
Provides support to members of Referral Management and Business Development departments during clinical review of referrals and coordination of admission.
Completes all necessary financial verifications to identify existing health insurance benefits and confirm primary payer sources. Ensures all requirements of payer are met prior to admission.
Initiate escalation process for referrals that meet yellow-light or red-light criteria.
Coordinates follow-up on referrals with Director of Business Development.
Responds to referrals/inquiries for admission and readmission within 15 minutes. This includes, but is not limited to, referrals received through Allscripts, e-fax, phone or EPIC.
Initiates managed care process and ensures that prior authorization is obtained from payer prior to admission.
Identify and request missing information from referral packets to include all required clinical, financial, and demographic information.
Communicates patient needs with facility staff including diagnosis, equipment needs, isolation needs, payer and other medical/financial information prior to admission to ensure facility readiness for patient.
Follows established communication expectations with team members, facility staff, leadership, and referral sources.
Demonstrates professional communication with all interactions.
Preforms other duties as assigned.
Participates in monthly weekend manager on duty rotations.

**Requisitos**:
RN or LPN (Preferred but not required)
High School diploma or equivalent
At least 2 to 3 years prior SNF Admissions experience.
High level of PC literacy preferred (Microsoft Office version 1997, 2000 or XP, MS Word, MS Access, MS Excel, E-mail, Outlook, Internet Explorer) Excellent written and verbal communication skills. Analytical and problem-solving skills
Team oriented and cooperative.
Basic knowledge for Medicare/Medicaid and Managed Care Organizations
Gracious and welcoming personality for customer service interaction
Ability to multi-task and remain calm under stress. Must meet all health requirements as required by law. Ability to read, write, speak, and understand English

Beneficios

Paid Health & Life Insurance
Perfect Attendance Bonus (Paid Monthly)