Clinical Referral Coordinator

Company: Legacy Healthcare
Location: Skokie
Posted on: November 25, 2022

Job Description:

Legacy Healthcare - Legacy Healthcare has an exciting opportunity for a Clinical Referral Coordinator! Are you a Registered Nurse (RN) or Licensed Practical Nurse (LPN) with Skilled Nursing experience who is looking to transition from bedside to a corporate business setting? -We have a great opportunity to utilize your clinical skills in our corporate office. - We offer scheduling flexibility with Hybrid/remote days option.
We offer great benefits and a collaborative corporate culture. - Benefits include:
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• Competitive wages.
  
• Tuition reimbursement.
  
• Internal growth opportunities.
  
• Comprehensive benefits package.
  
• 401K with employer match.
  
• Employee concierge program.
  
• And more!
  
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  Summary
  -The Central Intake Model aims to standardize the process of converting referrals into admissions through effective and efficient clinical and financial referral review. The Clinical Referral Coordinator assists referring agencies with patient placement through ensuring all pre-admission verifications and paperwork have been completed as well as assisting in the smooth transition of patients from hospital to facility. This is performed through excellent communication with facility staff and referring agencies.
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  Essential Functions
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  - - - - - - - Under the supervision of Corporate Director of Admissions and Clinical Director of Referral Management, assumes the responsibility for clinical and financial referral review.
  - - - - - - - Initiates contact with referral source or liaison to obtain all necessary clinical information to assess for clinical appropriateness of all referrals.
  - - - - - - - Collaborates with Clinical Leadership or building Clinical Administration for clinically complex referrals.
  - - - - - - - Coordinates with the Business Development Team for on-site assessments when deemed necessary.
  - - - - - - - Inputs all referrals into CRM in a timely and accurate manner.
  - - - - - - - Completes all financial verifications to confirm health insurance benefits, coverage, and identify the primary/secondary payers in CRM.
  - - - - - - - Identifies Medicaid Pending and Private payers and request for further documentation and review from the Medicaid team.
  - - - - - - - Understands the Managed Care process and authorization requirements. Initiates communication with Legacy Case Managers for benefits and payers requiring authorization prior to admission.
  - - - - - - - Runs background checks for criminal and sex offenders to identify any possible offenders.
  - - - - - - - Facilitates communication with referral source, Business Development Team, facility staff in a timely manner on the acceptance or denial of all referrals.
  - - - - - - - Ensures all relevant information regarding patient admission is communicated to facility. Ex. Diagnosis, special needs, dialysis, transportation, medical equipment, etc.
  - - - - - - - Completes Referral/Bedhold Log daily to reflect all referral activity and updates.
  - - - - - - - Creates patient profiles in electronic medical record for new admissions and updates existing profiles for bedholds.
  - - - - - - - Generates initial census line and payer tree for new admissions.
  - - - - - - - Maintains professional communication with all interactions including amongst team members, facility staff, organizational leadership, referral sources, etc.
  - - - - - - - Organizes and updates Forecast on a daily basis for external team members accessibility.
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  Qualifications and Experience
  - - - - - - - Bachelor's degree or equivalent
  - - - - - - - At least 2 years of prior SNF experience as an RN or LPN and unencumbered State of Illinois RN or LPN license. - -
  - - - - - - - High level of PC literacy preferred (Microsoft Word, Excel, Outlook)
  - - - - - - - Preferred experience with Point Click Care
  - - - - - - - Excellent written and verbal communication skills
  - - - - - - - Team oriented, analytical, and ability to multi-task
  - - - - - - - Basic knowledge of Medicare/Medicaid/Managed Care Organizations
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  Expected Hours of Work
  - - - - - - - This position is part of the Legacy Referral Management Department that runs 7 days a week from 7am-7pm. Weekend and Holiday work will be required.
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  Please note this job description is not designed to cover or contain a comprehensive listing of
  activities, duties or responsibilities that are required of the employee for their job. Duties,
  responsibilities, and activities may change at any time with or without notice.
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Keywords: Legacy Healthcare, Skokie , Clinical Referral Coordinator, Healthcare , Skokie, Illinois