Admissions Specialist (Masters Of Social Work)

Summary

Please note - A Master's Degree in Social Work is required for this position.

Responsibilities

Performs initial assessment of patient and coordinates patient care throughout the entire continuum of care by:

• Performing psychiatric assessments.

• Obtains initial authorization if applicable.

• Consulting with physicians and other health care providers to assure effective implementation of patients' plans of care.

• Communicating treatment recommendations made by the doctor, which may include coordination of community services, follow-up care, and education.

• Ensure completeness and accuracy of the medical record.

• Reporting patient outcome information to the manager.

• Assists with Social Work services on the inpatient units as needed.

• Notifying the assigned Unit of the patient's arrival.

• Preparing the patient's chart, ID band and labels for the medical record.

• Arranging for an escort to assist the patient to the assigned unit (by wheelchair or by walking with the patient).

• Participates in continuous quality improvement by compiling and analyzing data to generate reports which accurately represent utilization trends and patterns.

Registers patients in order to obtain demographic, physician and insurance information in accordance with established departmental policies and procedures by:

• Interviewing patients/obtaining collateral information via telephone for pre-admission or for admission upon presentation in the intake area or patient room.

• Obtaining identification, demographic, physician and insurance information from patients and accurately entering this information into the Hospital financial system.

• Updating the system after validation of the new patient's financial information.

• Pre-certify with the patient's insurance carrier in order to ensure maximum coverage to the limits of the insured's insurance policy.

• Requesting copies of the insurance card(s) and drivers license or other government picture ID to confirm insurance benefits and identification.

• Providing the Medicare letter for Medicare patients; also completing the Medicare Secondary Payor Questionnaire (MSP) and Advance Beneficiary Notice (ABN).

• Referring the patient to the Patient Account Liaison (PAL) if they are unable to secure satisfactory payment arrangements. Also assisting the PAL in obtaining additional patient information, copies of insurance card(s) and church information.

• Obtaining all required signatures for the 'consent to treat' and assignment of insurance benefits forms.

Coordinates both the Verification of Benefits (VOB) and Pre-certification/documentation (PA) processes for patients by:

• Verifying insurance coverage by calling the insurance company or using online eligibility systems to determine the patient's benefits under the insurance plan.

• Obtaining pre-certification information from the insurance company's pre-certification unit (i.e., whether pre-certification is required, if the ordering physician has completed it, etc.).

Qualifications

• The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a master's degree in social work or counseling field. A minimum of two years experience conducting psychiatric assessments is preferred.

• Knowledge & Skills

• Requires thorough knowledge of procedures and techniques required to treat targeted patient population.

• Demonstrates clear, effective communication and interpersonal skills, including verbal, written, and listening skills.

• Requires ability to independently prioritize and organize work activities and work effectively under pressure.

• Requires ability to identify and utilize appropriate resources.

• Demonstrates computer literacy and the ability to use various computer programs.

Working Conditions

• Works in various environments with frequent changes in job demands.

• Physical Demands

• Requires the physical ability and stamina to perform the essential functions of the position.