Job Description

Riverside Rehabilitation Hospital & Select Specialty Hospital Hampton Roads

A joint venture partnership with Select Medical and Riverside Health

Yorktown, VA

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

Full-Time, Monday through Friday, 8am - 5pm

The Clinical Assessment Specialist is a critical member of our hospital business development team, and in getting patients admitted to our acute inpatient rehabilitation hospital and our critical illness recovery hospital quickly, so patients can receive the care and services they need. Clinical Assessment Specialists assist the field clinical liaisons with Patient Assessment completion and pull-through. This position is a great step into the business side of healthcare, and helping patients in a unique way, away from the bedside. The Clinical Assessment Specialist must have an active, unencumbered RN, PT, OT, or SLP license.

Responsibilities

As a Clinical Assessment Specialist you will:

• Work with Admission Department (and/or acute care hospital personnel) to secure insurance authorization and/or coordination of benefits necessary to be admitted. Develop professional relationships with insurance case managers as appropriate.
• Assess a patient’s eligibility for and feasibility of post-acute services in consultation with the field Clinical Liaisons,Senior Clinical Liaison, or Director of Business Development. Review and analyze medical records and history that are key to a determination of suitability for post-acute services.
• Prepare and complete a detailed preadmission assessment timely and thoroughly, which meets all regulatory requirements. Documentation will reflect critical thinking and rationale for admission inclusive of medical necessity and projective needs.
• Participate in meetings with hospital leadership, DBD and clinical liaisons to provide market intelligence information and share strategies and results.
• Support team members in the field or in the admissions office as appropriate.
• Assist with insurance authorization backup as needed.
• Obtain timely authorization of all patients requiring pre-certification and are accountable for conversion percentage and results.
• Ensure 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.
• Identify by payor their preference or use the best practice coversheet and submission portfolio to the insurance company to maximize results.
• Develop and maintain professional credibility. Gain mutual respect and build confidence with leadership and teammates.
• Perform other related projects and duties as assigned.

Qualifications

Minimum Qualifications:

• Current and valid state licensure or eligibility for state licensure as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist required. Multi-state licensure required based on geographical territory.
• Two years 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 rehabilitation setting or in another post-acute care setting preferred.
• Demonstrated computer proficiency.
• Must exercise sound judgment in handling professional/confidential nature of health care information.

Additional Data

Why Join Us:

• Start StrongExtensive and thorough orientation program to ensure a smooth transition into our setting.
• Recharge & RefreshGenerous PTO to maintain a healthy work-life balance
• Your Health MattersComprehensive 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.