Remote Utilization Review Rn Jobs in Warren, OH (NOW HIRING)

Company:
Mercy Health Home Care and Hospice by Compassus
Position Summary
The Hospice Admissions Coordinator processes patient referrals, coordinates the admission of patients, and enters patient admission data after all requirements of hospice have been met.
Position Specific Responsibilities

• Support designated program area and/or region.
• Attends and participates in staff meetings, educational programs and community events, as requested.
• Communicates identified needs and potential solutions to supervisor.
• Receives and processes referrals from physicians, patients, families, friends, and community.
• Contacts physicians to secure an order for admission. If the Admissions Coordinator is not a Registered Nurse, s/he will have to ensure a nurse is present to take a verbal order or will have to ask for a "script" to be faxed.
• Contacts insurance companies for pre-certification authorization.
• Schedules appointments with patients and families for informed consents and the RN assessment visit.
• Explains hospice services and benefits to patients, family members, and significant others, if needed.
• Informs appropriate team members of time of appointments.
• Completes admission process according to agency/corporate policy.
• Ensures proper notification of admission to assigned interdisciplinary team (IDT) and ancillary providers.
• Enters admission data into a third-party system.
• Ensures patient chart, ensuring all documentation is signed and dated and turns chart over to Team Coordinator.
• Markets referral sources.
• Contacts long term care staff, hospital staff, and physicians to promote hospice services.
• Provides back-up support for Hospice Care Consultant.
• Documents marketing contacts, as directed.
• Performs other duties as assigned.

Education and/or Experience

• High school diploma or GED required.
• Bachelor's degree preferred.
• Two (2) to three (3) years of related experience and/or training strongly preferred. An equivalent combination of education and experience will be considered.
• Experience communicating with physicians, nurses and other healthcare personnel highly preferred.
• Experience in insurance and Medicare/Medicaid billing and reimbursement preferred.

Skills

• Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percentage.
• Language Skills: Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from leaders, team members, investors, and external parties. Strong written and verbal communications.
• Other Skills and Abilities: Ability to understand, read, write, and speak English. Articulates and embraces hospice philosophy.

Physical Demands and Work Environment: The demands of this role necessitate a team member to effectively perform essential functions. Adaptations can be made to accommodate team members with disabilities. Regular standing, walking, and manual dexterity are fundamental, along with the ability to lift and move objects up to 25 pounds. Visual acuity requirements include close and distance vision, color and peripheral vision, depth perception, and the ability to adjust focus. This description provides a general overview and may vary by role and department, capturing the nuanced demands and conditions inherent to positions in our organization.
At Compassus, including all Compassus affiliates, diversity, equity, and inclusion are fundamental to our Pillars of Success. We are committed to creating a fair work environment where our team members feel welcomed, highly valued, and respected. As an equal opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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