Job Description

Overview

Select specialty Hospital

Critical Illness Recovery Hospital

This is an on-site position. Remote work is not available. Candidates must be able to commute to this location.

Clinical Assessment Specialist (RN, OT, PT, or SLP)

• Salary Range: $70,000 - $95,000 per year depending on experience
• Location: This position is on-site at the hospital
• Schedule: Monday - Friday, 8 AM - 5 PM

A day in the life

As an integral part of our hospital business development team, the Clinical Assessment Specialist facilitates patient admissions to the rehabilitation hospital by assisting the field clinical liaisons with PAS completion and pull-through.

Responsibilities

Responsibilities:

• Works with Admission Department (and/or acute care hospital personnel) to secure insurance authorization and/or coordination of benefits necessary to be admitted. Develops professional relationships with insurance case managers as appropriate.
• Assesses a patient’s eligibility for and feasibility of rehabilitation services in consultation with the field Clinical Liaisons,Senior Clinical Liaison, or Director of Business Development. Reviews and analyzes medical records and history that are key to a determination of suitability for rehabilitative services.
• Prepares and completes a detailed preadmission assessment timely and thoroughly, which meets all regulatory requirements. Documentation reflects critical thinking and rationale for admission inclusive of medical necessity and projective rehabilitation needs.
• Participates in meetings with hospital leadership, DBD and clinical liaisons to provide market intelligence information and share strategies and results.
• Supports team members in the field or in the admissions office as appropriate
• Assist with insurance authorization backup as needed.
• Obtains timely authorization of all patients requiring pre-certification and is accountable for conversion percentage and results.
• Ensures all policies governing commercial pre-certification and authorization are followed to minimize financial risk.
• Maintain relationship profile by payor for payor case managers and medical directors.
• Identifies by payor their preference or uses the best practice coversheet and submission portfolio to the insurance company to maximize results
• Develops and maintains professional credibility. Gains mutual respect and builds confidence with leadership and teammates.
• Performs other related projects and duties as assigned.

Qualifications

Minimum Qualifications:

• Demonstrated computer proficiency.
• Must exercise sound judgment in handling the professional/confidential nature of health care information

Preferred Qualifications:

• Current and valid state licensure or eligibility for state licensure as a Registered Nurse or Respiratory Therapist
• Two years of related experience working in a clinical healthcare setting role.
• Demonstrated competency with the preadmission process including assessments, transitions of care communication, and patient pull-through.
• Previous experience in a hospital setting

Additional Data

Why Join Us:

• Start Strong: Extensive orientation program to ensure a smooth transition into our setting.
• Recharge & Refresh: Generous PTO to maintain a healthy work-life balance
• Your Health Matters: Comprehensive medical/RX, health, vision, and dental plan offerings
• Invest in Your Future: Company-matching 401(k) retirement plan, as well as life and disability protection
• Ease The Burden: Company paid parking
• Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care.

Equal Opportunity Employer, including Disabled/Veterans.