PRIMARY PURPOSE: Coordinate referrals and admissions with internal and external organizations and support Director of Admissions in overall duties.
ESSENTIAL DUTIES AND PRIMARY RESPONSIBILITIES:
A. Maintain current knowledge of budgeted census for Hillside Programs (Residential, Partial Hospitalization, Intensive Outpatient, Community Intervention, Intensive In-Home Therapy, and Outpatient Program(s)) and stay abreast of upcoming discharges and admissions, as well as forecasting census ongoing.
B. Accurate and timely entry of all billing related data into Avatar. Timely follow-up on any billing related issues related to front office issues to include Coordination of Benefits, secondary insurance, and initial authorizations. Quality control of billing related data in Avatar at least weekly.
C. Process and coordinate referrals and/or information calls/requests into Salesforce. Conduct tours as necessary with potential admissions or new referral sources. Maintain and update referral paperwork and files in accordance with accreditation standards.
D. Prepare and maintain all admission paperwork, assist guardians with admission consent forms and distribute to appropriate departments. Ensure all necessary documentation is in child’s record according to Hillside policies, State Regulations, Licensing requirements, DOE requirements and accreditation standards
E. Maintain current data in EHR or Spreadsheets of all intake calls, referrals, admissions, and denials for all programs as well as all required information regarding referral sources for Hillside as well as in accordance with accreditation standards.
F. Ensure child’s Medicaid, Private Insurance and any Pharmacy cards and information are forwarded to appropriate departments.
G. Obtain appropriate information on all referrals for benefits, copays and deductibles prior to admission to any of the Hillside Programs. Check referral benefits via phone and Waystar.
H. Complete Preauthorization with all External Review Organizations (ERO) prior to admission for any Private Insurance or CMO referrals.
I. Remain current with changing policies with Medicaid funding with Hillside’s programming and assist guardians and staff with understanding of Medicaid funding options.
J. Perform other duties as deemed necessary by a Manager or Administration.
GENERAL COMPETENCIES:
Customer Focus
A. Promote positive image of Hillside with all contacts (customers)
B. Exhibit high quality of work
C. Contribute to development of a culture of care
Teamwork
A. Take the initiative to act on own
B. Demonstrate cooperation
C. Be a productive member of the staff
Communication
A. Communicate Effectively, clearly, and appropriately
B. Make use of supervision
C. Use excellent Judgment
CORE COMPETENCIES:
A. Knowledge of the continuum of care, including all programs inside and outside of Hillside, and admissions process and the ability to communicate this effectively, both orally and in writing.
B. Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work and to determine the appropriate course of action in more complex situations in an accurate and timely fashion.
C. Ability to handle difficult situations involving patients, parents, clinical team or others in a professional manner.
D. Establish and maintain effective working relationships at all organizational levels, as well as with other agencies and the public.
JOB SPECIFIC COMPETENCIES:
A. Maintain current knowledge of budgeted census for Hillside Programs (Residential, Partial Hospitalization, Intensive Outpatient, Community Intervention, Intensive In-Home Therapy, and Outpatient Program(s) and stay abreast of upcoming discharges and admissions, as well as forecasting census ongoing.
B. Process and coordinate referrals and/or information calls/requests while maintaining and updating referral paperwork and files in accordance with accreditation standards. Maintain current data in EHR or Spreadsheets of all intake calls, referrals, admissions, and denials for all programs as well as all required information regarding referral sources for Hillside as well as in accordance with accreditation standards.
C. Prepare and maintain all admission paperwork, assist guardians with admission consent forms and distribute to appropriate departments. Ensure all necessary documentation is in child’s record according to Hillside policies, State Regulations, Licensing requirements, DOE requirements and accreditation standards.
D. Obtain appropriate information on all referrals for benefits, copays and deductibles prior to admission to any of the Hillside Programs.
