Admissions Coordinator

CareRing Health; Philadelphia (Philadelphia County); On-site; USD 40,000 - 80,000; Full time

Job summary

Join a compassionate healthcare team dedicated to enhancing the lives of patients in their homes. This role involves overseeing patient care, managing prior authorization requests, and ensuring compliance with established processes. You will collaborate with nursing staff and other healthcare professionals to provide exceptional service and support quality improvement initiatives. The organization values work-life balance, offering flexible hours and a collaborative environment. If you are passionate about making a difference in the healthcare sector and possess strong communication and organizational skills, this opportunity is perfect for you.

Benefits

Flexible hours/work-life balance

Medical/dental/vision/life insurance

Paid holidays/PTO/401(k) match

Career growth opportunities

Collaborative work environment

Qualifications

• 3+ years of experience in a medical setting required.
• Strong communication skills are essential for patient interactions.

Responsibilities

• Oversee patient care continuity and manage prior authorization requests.
• Communicate with members and providers about benefit issues.

Skills

Data Entry

Clinical Documentation

Communication Skills

Medical Review Process

Quality Care Coordination

Education

3 years experience in a medical setting

Experience with hospice agency

Tools

Computer Access for Medical Information

Job description

Overview

Immediate Home Health and Hospice is a leading provider of home health and hospice services in the Philadelphia, PA area. Our mission is to provide exceptional home health and hospice services to patients who need our help the most.

We are seeking talented, passionate individuals to join our team and help our patients live happier and healthier lives…in their homes.

What We Offer:

• Be part of a unique healthcare company where we can help those in our communities who need our help the most
• Flexible hours/work-life balance (full-time or part-time available)
• Competitive pay
• Paid on a weekly basis
• Medical/dental/vision/life insurance
• Paid holidays/PTO/401(k) match
• Career growth opportunities
• Great and collaborative work environment

Responsibilities

Position Summary: You will work on a full-time basis to oversee and provide the best continuity of patient care by the Admissions Coordinator, who will work within Immediate Home Health & Hospice requirements for completion and turnaround times for requests and assists with adherence to established processes.

Responsibilities include but are not limited to:

1. Perform data entry and case review of prior authorization requests submitted to the Medical Management department.
2. Gather clinical documentation for case preparation. Assist in the medical review process of authorization requests and claims review as appropriate to assist in making medical necessity decisions and benefit determinations.
3. Communicate with members and providers regarding benefit issues and keep up to date on health plans and benefits associated with each type of plan.
4. Maintain documentation of decision-making regarding each case.
5. Work closely with other nursing staff to discuss cases and make determinations.
6. Communicate with clinic and other requesting facility staff and practitioners to obtain additional information for case documentation.
7. Maintain proficiency in the use of computer access to obtain medical information needed.
8. Attend daily stand-up and stand-down meetings.
9. Assist with writing and sending of non-authorization letters.
10. Take accurate and complete telephone messages and refer calls to RN as necessary.
11. Identify and refer potential quality of care issues to RN Case Manager for follow-up.
12. Attend and actively participate in Medical Management Meetings.
13. Participate in Medical Management activities and attend departmental in-services as scheduled.
14. Assist with the second review of claims.
15. Participate in internal quality reviews to support continuous quality improvement initiatives within the department.
16. Support Quality Care Coordinators with programs as necessary.
17. Adhere to and uphold Immediate Home Care & Hospice Mission, Vision, and Values and Health Service & Performance Standards.
18. Other duties as assigned.

Qualifications

Qualifications:

• 3 years working in a medical setting.
• Experience working with a hospice agency (preferred).

*Eligibility for certain benefits may depend on employment status.

Immediate Home Health and Hospice is an equal opportunity employer committed to providing equal employment opportunities without regard to race, color, religion, sex (including pregnancy), sexual orientation, age, national origin, disability, genetic information, veteran status, or any other classification protected by applicable law.