Whittier Health Network
Published
December 2, 2021
Category
Job Type

Description

Admissions RN Clinical Specialist - Full Time

Primary Responsibilities:
• Responsible for reviewing potential patients pre‐admission screening, inclusive of pertinent medical and financial information to ensure hospital payment capability.
• Develops, maintains, and evaluates systems to ensure appropriate levels of care according to 3rd party payers and other accrediting agencies’ standards.
• Supervises and assists in all aspects of the referral and admission process.
• Ensures clinical appropriateness of all patients admitted.
• Ensures insurance pre‐authorization requirements are met on all patients admitted.
• Demonstrates the ability to complete pre‐admission assessments on potential candidates for admission and render definitive clinical decisions.
• Determines if the patient is likely to benefit significantly from an intense hospital level rehabilitation program of extensive inpatient evaluation.
• Complies with corporate standards regarding financial clearance of referrals/ admissions.
• Demonstrates geriatric and rehabilitation knowledge and principles.

Prerequisites:
• Registered Nurse with current Massachusetts license, BSN preferred; or Bachelors of Science in health related field; or Licensed Practical Nurse with 5+ years clinical experience.
• Knowledge of all aspects of the admission process, including insurance verification, and pre‐certification.
• Working knowledge of the insurance industry and how it relates to the admissions process.
• Ability to coordinate, manage and prioritize multiple projects and tasks.
• Ability to operate standard office equipment such as personal computer, copy machine, and fax machine.
• Possess a regard for confidentiality.
• Knowledge of administrative policies and procedures.
• Effective communication skills, both oral and written.
• Current driver’s license and an accessible automobile.

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