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8110 Gatehouse Road, Falls Church, VA 22042

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Registered Nurse Liaison - Rehabilitation Admissions

Mount Vernon Hospital 619049 Full Time 2501 Parkers Lane, Alexandria, VA, 22306, US
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Job Description

As a Rehabilitation Admissions Liaison, you will develop and foster positive relationships with ongoing and potential referral sources. To help achieve our mission, you will anticipate and monitor changes in market trends and referral patterns. Assisting with plans and presentations of program information to referral sources, patients, families and professionals is of vital importance. Your ability to effectively communicate with internal/external contacts in a collaborative style that is timely and meets the needs of referral sources, healthcare team members, patients and families is essential. Facilitating the rehabilitation admission and referral process is required. Maintaining a working knowledge of insurance authorization and benefits requirements for rehabilitation services for programs, facilities and payers is expected.

Job Responsibilities
 
  • Builds close relationships with assigned hospital discharge planners, payer contacts and Physicians through routine contact as determined by volume of referrals. Identifies issues/needs and works to resolve them. Anticipates problems with potential referral sources and offers solutions.
  • Follows-up promptly when customer needs are not met and problems occurs. Contacts customers within 24 hours with problem resolutions. Solicits feedback from top referrals. Tracks and uses data from direct contacts, internal feedback or surveys conducted to identify and address issues per discussions with coordinators and directors.
  • Makes five marketing/referral development calls/visits per week. Schedules quarterly contact with low volume referral sources. Identifies sources for increased referrals in assigned geographic regions per discussions with coordinators.
  • Responds to voicemail messages within one hour during business days or by 8:30 am the next business day if messages are received after hours of operation. Responds to pages immediately or as soon as safe to do so if driving.
  • Communicates referral decisions clearly by including reasons for decisions if admissions are denied/deferred or if timeframes for delays and requirements are needed to finalize decisions (e.g. MD consult, payer clarification, unresolved medical issues, etc.).
  • Provides timely and specific information to team and bed assignment personal as soon as confirmation is determined from referral sources, payers or other parties. Communicate special circumstances to program staff to facilitate customer satisfaction and meet special needs as indicated by concerns or program staff feedback. Anticipates issues or concerns of referral sources and seeks proactive solutions. Seeks feedback and maintains ongoing communication channels with potential and current referral sources.
  • Maintains working knowledge of insurance authorization and benefits requirements for rehabilitation services for programs, facilities and payers.
  • Acquires payer information on all referrals and forwards to program registration staff when referrals are received. Completes necessary research or inquiries to determine payer source if not immediately available per referral source. Follows through to completion if additional work is required per discussion with coordinators. Obtains authorization numbers within payer defined timeframes and forwards to patient registration staff within three days of admission.
  • Provides any documentation, treatment plans, estimated length of stay or other payer defined information to complete pre-authorization. Correctly identifies opportunities to negotiate payment rates. Completes all necessary steps per program parameters. Completes required documentation to ensure correct billing. Communicates limitations of payers, benefits and impact on rehabilitation decisions and patient financial responsibilities based on feedback and reports.
  • Plans daily schedules to complete all assessments within 24 hours. Gathers medical, psycho-social and demographic information through chart review and interviews to form a clear picture of rehabilitation needs and appropriate admission decisions.
  • Identifies medical conditions, discharge needs or reimbursement issues that present barriers for proceeding with the admission process.
  • Provides prompt notification of admission decisions to referral sources, payers, program staff, patients and families.

Requirements:

* Two years clinical experience in acute rehab, ICU or Med/Surg required. Five years experience preferred.
* Case Manager experience preferred.
* Must possess BSN and license to practice as an RN in Virginia (or compact designation).

For internal use:  IND1

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Additional Requirements