Clinical Admission Reviewer
Location: Remote – New York
Schedule: Full-Time | Monday–Friday | 9:00 AM – 5:00 PM
Salary: $75,000 Annually
Position Summary
We are seeking an experienced and detail-oriented Clinical Admission Reviewer with a strong background in Skilled Nursing Facility (SNF) admissions. This remote role supports the admissions process across multiple Skilled Nursing Facilities and plays a critical role in reviewing clinical documentation, evaluating admission appropriateness, and ensuring compliance with regulatory and payer requirements.
The Clinical Admission Reviewer will collaborate closely with Admissions Directors, Admissions Coordinators, and facility leadership teams to facilitate timely admissions, optimize census growth, and maintain compliance with all applicable healthcare regulations.
Key Responsibilities
Review referral and clinical documentation to determine appropriateness for admission to Skilled Nursing Facilities across multiple locations.
Evaluate referrals based on facility capabilities, clinical criteria, and payer requirements.
Provide coverage for Admissions Directors during weekends, holidays, vacations, or as needed.
Communicate with hospitals, discharge planners, case managers, and facility teams regarding admission status and authorization updates.
Obtain and manage insurance authorizations and payer approvals for admissions.
Maintain accurate documentation related to referral reviews, authorizations, and admission decisions.
Ensure compliance with Medicare, Medicaid, Managed Care, and commercial insurance requirements.
Stay current on state and federal regulations related to admissions, transfers, and reimbursement processes.
Support facility census development initiatives through efficient referral management and admission review processes.
Collaborate with interdisciplinary teams to ensure smooth transitions of care and timely admissions.
Qualifications
Minimum of three (3) years of Skilled Nursing Facility (SNF) experience.
Strong knowledge of Medicare, Medicaid, Managed Care, and payer authorization processes.
Experience reviewing clinical documentation for admission appropriateness.
Knowledge of portal systems and payer authorization platforms.
Proficiency with EMR and referral management systems, including:
Familiarity with state and federal healthcare regulations related to admissions and transfers.
Excellent communication, organizational, and time-management skills.
Ability to manage referrals for multiple facilities and prioritize competing deadlines in a fast-paced environment.
Strong analytical and clinical assessment skills.
Proficiency with Microsoft Office Suite and remote communication platforms.
Previous experience in admissions, case management, utilization review, or managed care.
Experience working remotely and independently.
Licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) preferred but not required.
Benefits
Comprehensive Medical and Dental Coverage
Generous Paid Time Off (PTO)
401(k) Retirement Plan
Employee Recognition Program
Supportive, Team-Oriented Work Environment
Company Perks and Employee Discounts
Opportunities for Professional Growth and Development
Why Join Our Team?
Join a growing healthcare organization dedicated to providing exceptional post-acute care services. As a Clinical Admission Reviewer, you will play a vital role in supporting admissions operations, ensuring regulatory compliance, and helping patients access the care they need. This is an excellent opportunity to make a meaningful impact while working in a collaborative and supportive remote environment.
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