About this role
Overview
California Rehabilitation Institute
*A partnership with Select Medical, Cedars-Sinai, and UCLA Health*
Los Angeles, CA
Clinical Assessment Specialist (RN, PT, OT, SLP)
Salary: $90,000 - $115,000 salary, based on experience
Schedule: Full-Time, onsite
Hired candidate will work Saturday - Wednesday, 8am - 5pm
The Clinical Assessment Specialist is a critical member of our hospital business development team, and in getting patients admitted to our acute inpatient rehabilitation hospitals quickly, so patients can receive the care and services they need. Clinical Assessment Specialists assist the field clinical liaisons with Patient Assessment completion and pull-through. This position is a great step into the business side of healthcare, and helping patients in a unique way, away from the bedside. The Clinical Assessment Specialist must have an active, unencumbered RN, PT, OT, or SLP license.
Responsibilities
Responsibilities:
- Works with Admission Department (and/or acute care hospital personnel) to secure insurance authorization and/or coordination of benefits necessary to be admitted. Develops professional relationships with insurance case managers as appropriate.
- Assesses a patient’s eligibility for and feasibility of rehabilitation services in consultation with the field Clinical Liaisons,Senior Clinical Liaison, or Director of Business Development. Reviews and analyzes medical records and history that are key to a determination of suitability for rehabilitative services.
- Prepares and completes a detailed preadmission assessment timely and thoroughly, which meets all regulatory requirements. Documentation reflects critical thinking and rationale for admission inclusive of medical necessity and projective rehabilitation needs.
- Participates in meetings with hospital leadership, DBD and clinical liaisons to provide market intelligence information and share strategies and results.
- Supports team members in the field or in the admissions office as appropriate
- Assist with insurance authorization backup as needed.
- Obtains timely authorization of all patients requiring pre-certification and is accountable for conversion percentage and results.
- Ensures all policies governing commercial pre-certification and authorization are followed to minimize financial risk.
- Maintain relationship profile by payor for payor case managers and medical directors.
- Identifies by payor their preference or uses the best practice coversheet and submission portfolio to the insurance company to maximize results
- Develops and maintains professional credibility. Gains mutual respect and builds confidence with leadership and teammates.
- Performs other related projects and duties as assigned.
Qualifications
Minimum Qualifications:
- Current and valid state licensure or eligibility for state licensure as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist required. Multi-state licensure required based on geographical territory.
Preferred Qualifications:
- Two years related experience working in a clinical healthcare setting role. Demonstrated competency with the preadmission process including assessments, transitions of care communication, and patient pull-through. Previous experience in a rehabilitation setting or in another post-acute care setting preferred.
- Demonstrated computer proficiency.
- Must exercise sound judgment in handling professional/confidential nature of health care information.
Additional Data
Why Join Us:
- Start Strong : Extensive orientation program to ensure a smooth transition into our setting.
- Recharge & Refresh : Generous PTO to maintain a healthy work-life balance
- Your Health Matters : Comprehensive medical/RX, health, vision, and dental plan offerings
- Invest in Your Future: Company-matching 401(k) retirement plan, as well as life and disability protection
- Ease The Burden: Company paid parking
- Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care.
Equal Opportunity Employer, including Disabled/Veterans.