Admissions Specialist

The Admissions Specialist's role is multifaceted, encompassing referral coordination and authorization management. The Add ongoing service authorizations.

Continued monitoring of service authorizations through Electronic Health Record reporting is another responsibility, guaranteeing service coverage for reimbursement.

In cases where authorization approvals are incorrect or not as requested, the Admissions Specialist diligently follows up with payers.

Regular communication with direct care staff and leadership regarding authorization matters, including notifications of approvals, denials, and authorizations nearing exhaustion, is maintained.

• The Admissions Specialist supports staff in managing authorization-related issues and ensures timely paperwork and clinical documentation submission.
• Process Adherence : Adhere to established processes and procedures set forth by Central Business Operations leadership to maintain a standardized and efficient referral process.
• Referral Management : Process all incoming agency referrals and ensure accurate information is associated with each client entry.

This includes assisting clients in scheduling intake appointments ensuring a smooth and efficient intake process.

• Authorization Monitoring : Submit any initial authorizations and monitor all existing authorizations via Electronic Health Record reporting and payer portals for all programs to ensure service coverage for reimbursement.
• Authorization Follow-Up : Follow up with relevant payers if the initial or reauthorization approval needs to be corrected or amended.
• Staff Notification : Keep regular correspondence with direct care staff and leadership regarding authorization issues, including notification of authorization approvals, denials, and near exhaustion / exhaustion.
• Recording : Continuously update the Electronic Health Record with pertinent authorization-related information.
• Staff Support : Support staff concerning authorization-related issues, including communicating with direct care staff and leadership to ensure all appropriate paperwork and clinical documentation supporting the authorization process is submitted promptly.
• Tracking : Maintain referral tracking and manage referral data, client information, and other relevant information.
• Fax Management : Receive and route incoming faxes and other documents, ensuring they promptly reach the appropriate staff members.
• Incoming Calls : Answer agency phone calls, respond to inquiries, route calls to the appropriate personnel, and provide excellent customer service to clients and stakeholders.
• Meetings : Attend and actively contribute to staff meetings within the Authorizations Team.
• Training : Attend relevant training to stay updated on industry best practices, regulatory changes, and emerging trends.
28 days ago