Rehab Admissions Liaison

Employer
Inova Health System
Location
Alexandria, VA
Posted
Nov 23, 2021
Closes
Dec 04, 2021
Ref
238112524
Function
Accountant, IT
Industry
Healthcare
Hours
Full Time
Inova : Inova's mission is to provide world-class healthcare - every time, every touch - to each person in every community we have the privilege to serve.Inova is the only health system in the country where all 5 hospitals received five-star rankings from the Centers for Medicare and Medicaid Services; they are the only hospitals in the Washington, DC region to have earned the highest rating from the federal agency. Inova is home to prominent clinicians and scientists, who drive innovation to improve patient care, prevent disease and promote wellness.Develops and fosters positive relationships with ongoing and potential referral sources. Anticipates and monitors changes in market trends and referral patterns. Assists with plans and presentations of program information to referral sources, patients, families and professionals. Effectively communicates with both internal and external contacts in a collaborative style that is timely, that meets the needs of the referral source, care team member, patient or family and facilitates the rehab admission and referral process. Maintains working knowledge of insurance authorization and benefits requirements for rehabilitation services for program, facility and payor. Acquires and disseminates accurate payer information to facilitate the admission process, clarify any uncertainties and finalize authorization for admission. Performs baseline and ongoing assessment of potential patients, and gathers all pertinent information regarding referral as defined by program policy. Understands rehab diagnoses, prognosis and clinical indicators in order to make an appropriate decision regarding admission to rehab program.Job ResponsibilitiesBuilds close relationships with assigned hospital discharge planners, payer contacts and physicians through routine contact as determined by volume of referrals. Identifies issues or needs of above and works to resolve concerns or problems as evidenced by referral feedback and surveys. Anticipates problems with potential referral sources and offers solutions. Follow up promptly when customer needs are not met and problems occurs. Contact customer within 24 hours with problem resolution. Solicit feedback from top referrals. Track and use data from direct contact, internal feedback or surveys conducted to identify and address issues per discussion with coordinator and director. Makes five marketing/referral development calls/visits per week. Schedule quarterly contact with low volume referral sources. Identify sources for increased referrals in assigned geographic region per discussion with coordinator.Responds to voicemail messages within one hour during business day or by 8:30 am the next business day if message received after hours. Responds to pages immediately or as soon as safe to do so if driving. Communicate referral decision clearly including reason for decision if admission denied/deferred, or time-frame for delay and requirements needed to finalize decision (eg MD consult, payer clarification, unresolved medical issue or other) as evidenced by referral source feedback and satisfaction surveys.Provides timely and specific info to team/bed assignment person as soon as confirmation determined from referral source, payer or other party as evidenced by program staff feedback. Communicate special circumstances to program staff to facilitate customer satisfaction and meet special needs as indicated by concerns or program staff feedback. Anticipates issues or concerns of referral sources and seeks proactive solutions. Seeks feedback and maintains ongoing communication channels with potential and current referral sources as evidenced by anecdotal and formal feedback.Maintains working knowledge of insurance authorization and benefits requirements for rehabilitation services for program, facility and payer.Acquire payer information on all referrals and forward to program registration staff when referral received as evidenced by patient registration feedback. Completes necessary research or inquiries to determine payer source if not immediately available per referral source. Follows through to completion if additional work required per discussion with coordinator. Obtain authorization numbers within payer defined time frames and forward to patient registration staff within 3 days of admission.Provide any documentation, treatment plans, estimated length of stay or other payer defined information to complete pre-authorization. Correctly identifies opportunity to negotiate rate of payment. Completes all necessary steps per program parameters. Completes required documentation to insure correct billing as evidence by lack of technical denials. Communicates limitations of payer and benefits and impact on rehab decision and patient financial responsibilities based on feedback and report.Plans daily schedule to complete all assessments within 24 hour time frame as evidenced by report and referral source feedback. Gathers medical, psycho-social and demographic information through chart review and interviews to form a clear picture of rehab needs and appropriate admission decision as indicated on assessment form.Identifies medical conditions, discharge needs or reimbursement issues that present barriers for proceeding with admission process as evidenced by discussion and documentation on intake form. Provides prompt notification of admission decision to referral source, payer, program staff and patient/family as evidenced by referral source feedback.Requirements:Two years clinical experience in acute rehab, ICU or med/surg required. Five years experience preferred.Must possess BSN and license to practice as an RN in Virginia (or compact designation).For internal use: IND1#LI-TH1Additional Requirementsn/aInova : Inova's mission is to provide world-class healthcare - every time, every touch - to each person in every community we have the privilege to serve.Inova is the only health system in the country where all 5 hospitals received five-star rankings from the Centers for Medicare and Medicaid Services; they are the only hospitals in the Washington, DC region to have earned the highest rating from the federal agency. Inova is home to prominent clinicians and scientists, who drive innovation to improve patient care, prevent disease and promote wellness.Develops and fosters positive relationships with ongoing and potential referral sources. Anticipates and monitors changes in market trends and referral patterns. Assists with plans and presentations of program information to referral sources, patients, families and professionals. Effectively communicates with both internal and external contacts in a collaborative style that is timely, that meets the needs of the referral source, care team member, patient or family and facilitates the rehab admission and referral process. Maintains working knowledge of insurance authorization and benefits requirements for rehabilitation services for program, facility and payor. Acquires and disseminates accurate payer information to facilitate the admission process, clarify any uncertainties and finalize authorization for admission. Performs baseline and ongoing assessment of potential patients, and gathers all pertinent information regarding referral as defined by program policy. Understands rehab diagnoses, prognosis and clinical indicators in order to make an appropriate decision regarding admission to rehab program.Job ResponsibilitiesBuilds close relationships with assigned hospital discharge planners, payer contacts and physicians through routine contact as determined by volume of referrals. Identifies issues or needs of above and works to resolve concerns or problems as evidenced by referral feedback and surveys. Anticipates problems with potential referral sources and offers solutions. Follow up promptly when customer needs are not met and problems occurs. Contact customer within 24 hours with problem resolution. Solicit feedback from top referrals. Track and use data from direct contact, internal feedback or surveys conducted to identify and address issues per discussion with coordinator and director. Makes five marketing/referral development calls/visits per week. Schedule quarterly contact with low volume referral sources. Identify sources for increased referrals in assigned geographic region per discussion with coordinator.Responds to voicemail messages within one hour during business day or by 8:30 am the next business day if message received after hours. Responds to pages immediately or as soon as safe to do so if driving. Communicate referral decision clearly including reason for decision if admission denied/deferred, or time-frame for delay and requirements needed to finalize decision (eg MD consult, payer clarification, unresolved medical issue or other) as evidenced by referral source feedback and satisfaction surveys.Provides timely and specific info to team/bed assignment person as soon as confirmation determined from referral source, payer or other party as evidenced by program staff feedback. Communicate special circumstances to program staff to facilitate customer satisfaction and meet special needs as indicated by concerns or program staff feedback. Anticipates issues or concerns of referral sources and seeks proactive solutions. Seeks feedback and maintains ongoing communication channels with potential and current referral sources as evidenced by anecdotal and formal feedback.Maintains working knowledge of insurance authorization and benefits requirements for rehabilitation services for program, facility and payer.Acquire payer information on all referrals and forward to program registration staff when referral received as evidenced by patient registration feedback. Completes necessary research or inquiries to determine payer source if not immediately available per referral source. Follows through to completion if additional work required per discussion with coordinator. Obtain authorization numbers within payer defined time frames and forward to patient registration staff within 3 days of admission.Provide any documentation, treatment plans, estimated length of stay or other payer defined information to complete pre-authorization. Correctly identifies opportunity to negotiate rate of payment. Completes all necessary steps per program parameters. Completes required documentation to insure correct billing as evidence by lack of technical denials. Communicates limitations of payer and benefits and impact on rehab decision and patient financial responsibilities based on feedback and report.Plans daily schedule to complete all assessments within 24 hour time frame as evidenced by report and referral source feedback. Gathers medical, psycho-social and demographic information through chart review and interviews to form a clear picture of rehab needs and appropriate admission decision as indicated on assessment form.Identifies medical conditions, discharge needs or reimbursement issues that present barriers for proceeding with admission process as evidenced by discussion and documentation on intake form. Provides prompt notification of admission decision to referral source, payer, program staff and patient/family as evidenced by referral source feedback.Requirements:Two years clinical experience in acute rehab, ICU or med/surg required. Five years experience preferred.Must possess BSN and license to practice as an RN in Virginia (or compact designation).For internal use: IND1#LI-TH1Additional Requirementsn/a

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