Overview:
Come join the TrustPoint Hospital Team as a Pre Admissions Indicator Coordinator for our Inpatient Physical Rehab Unit and make a difference every day! Apply now to learn more!
FULL TIME
*Skilled LPN with clinical and medical coding experience preferred*
TrustPoint Benefits:
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Competitive salary commensurate with experience.
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Referral Bonus
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Comprehensive benefits package, including medical, dental, and vision coverage.
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401(k) plan
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Continuing education and professional development opportunities.
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Generous paid time off and vacation policies.
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Supportive work environment that values teamwork and collaboration.
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Cutting-edge medical facilities and advanced technologies.
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Opportunities for career growth and advancement.
Responsibilities:
- Serve as the primary point of contact for patients and visitors seeking admission to our facility
- Collect and verify patient information, including insurance details and medical history
- Schedule appointments and coordinate with healthcare providers to ensure timely and efficient admissions
- Provide excellent customer service by addressing patient inquiries and concerns in a professional and compassionate manner
- Maintain accurate and up-to-date records of patient admissions, transfers, and discharges
- Adhere to all relevant healthcare regulations, including HIPAA guidelines, to ensure patient privacy and confidentiality
- Collaborate with other departments to facilitate smooth admissions processes
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities:
ESSENTIAL FUNCTIONS:
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Act as liaison between managed care organizations and the facility professional clinical staff.
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Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
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Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
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Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
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Conduct quality reviews for medical necessity and services provided.
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Facilitate peer review calls between facility and external organizations.
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Initiate and complete the formal appeal process for denied admissions or continued stay.
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Assist the admissions department with pre-certifications of care.
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Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
Qualifications:
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
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Associate's degree in nursing (LPN or RN) required. Bachelor's or Master’s degree in social work, behavioral or mental health, nursing or other related health field preferred.
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Two or more years' experience with the population of the facility and previous experience in utilization management preferred.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Current licensure as an LPN or RN within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
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CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
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First aid may be required based on state or facility requirements.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.
LPNF