Admission Specialist

Position Summary:

Coordinates the admissions process including insurance pre-authorization for admission. Candidate must have experience working with health insurance companies, performing account set-up & management, have medical terminology knowledge, possess excellent computer skills and be detail oriented. Experience in Behavioral Health setting is also preferred.

Essential Job Functions:

• Documents all incoming calls regarding admissions and accurately inputs all necessary information into admissions database.
• Verifies insurance by checking enrollment and funding status in multiple databases and documents insurance benefits in admission database prior to admission.
• Facilitates completion of any client information, financial payments, authorizations or other documentation at the time of admission.
• Maintain proper balance regarding source of payment (fee for service, BHO/NBH, public, private and third party payers)
• Responsible for educating clients on benefits and opportunities within the WestCare system.
• Resolves any issues with coverage and escalates complicated issues to the department manager and/or director.
• Coordinate with the billing specialists to assure all admissions/transfers/discharges are completed within the appropriate time frame.
• Work collaboratively with treatment teams of all programs, communicating information needed to maximize good customer service to clients, referral sources and third party payers.

• Maintain daily census and provide census information to internal and external sources on a timely basis.
• Assist all clients with application process for Medicaid by assisting with completion of the application, addressing any questions or concerns and helping the client to find the most appropriate coverage option available.
• Relay reporting information to Assistant Director of Billing regarding non-insured clients, daily.
• Perform other duties as assigned.

Essential Qualifications:

Certifications/Licenses:

• Must have the ability to obtain CPR & First Aid Certification and an Annual Tuberculosis Test;
• Ability to pass first level and NABS background clearance

Education:

• High School Diploma or equivalent and two-years of college-level education is preferred.

Experience and Competencies:

• Two years of admissions and insurance verification experience, preferred;
• Must be culturally/linguistically sensitive to populations served;
• Knowledge of the Criminal Justice System, preferred
• Knowledge/Experience with Substance Abuse / Behavioral Health clientele, preferred
• Be able to multi-task;
• Advanced computer skills;
• Excellent documentation & communication skills;
• Must have the ability to pass a criminal history background screening

Working Conditions:

• Work is primarily performed in an office, or treatment setting

Essential Physical and Mental Demands of the Job

The employee must be able to perform the following essential duties and activities with or

without accommodation:

Physical Demands:

• Normal work routine does not involve any exposure to blood, bodily fluids or tissues BUT exposure or potential exposure may be required as a condition of employment. Appropriate personal protective equipment will be readily available to every employee engaged in Category II tasks;
• Occasional lifting of more than 10 pounds;
• Sitting, standing, walking, reaching are performed in the normal course of the position.