Job Description
Required Qualifications An unencumbered nursing license in the state, LPN/LVN or RN. Must have, as a minimum, one (1) year of experience with demonstrated success in a nursing position in the facility or in another related health care facility. Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations and guidelines pertaining to long-term care. Major Duties and Responsibilities Participates in an open and collaborative relationship between the business office and the admissions office, both working toward shared facility goals for occupancy and collections. Performs duties daily in the admissions office as assigned by the Admissions Director to facilitate the conversion of referrals to admission status. Knows at all times, the status of each referral. Communicates with external team members regarding referral status and any additional information needed to assist with the admission decision. Reviews referrals for medical approval and communicates findings to the Admissions Director for decision. Consults with the Director of Nursing regarding facility capabilities as needed based on the most recent Facility Assessment. Reviews medications on referrals and performs an analysis regarding availability of medications and clinical capabilities of nursing staff based on the most recent Facility Assessment. Consults with the Director of Nursing to assist with the admission decision as needed. Transcribes physician's orders and queries the physician as needed to ensure accuracy of resident medical information prior to admitting the resident. Reviews and evaluates resident diagnoses and overall condition related to Medicare part A criteria for skilled coverage as well as related to Medicaid medical eligibility criteria for long term care placement prior to admitting the resident. Maintains working knowledge of Medicare Part A skilled coverage guidelines and Medicaid medical eligibility criteria for long term care residents. Assists with processing referrals timely on a daily basis as assigned by the Admissions Director. Identifies and documents primary and other diagnoses codes for all admissions and readmissions in the medical record based on a review of the available medical information. Maintains working knowledge of the
ICD-10 CM
coding process and is competent in the use of the ICD-10 CM
coding manual. Maintains a working knowledge of the Patient Driven Payment Model related to primary diagnosis and the clinical mapping for payment categorization. Is cross-trained in all functions performed by the Admissions Coordinator and performs duties as needed or assigned by the Admissions Director. Knows, at all times, which payment entities require prior authorization for payment and secures prior authorization when required. Maintains working knowledge of facility's practices related to all pay status types such as other insurances, Medicare A, Medicaid, Private, Veteran's Administration contracts, and hospital contracts, etc. May at times be required to complete mental health screenings as required by federal and state regulations prior to admission. Maintains working knowledge of facility's practices related to all pay status types such as other insurances, Medicare A, Medicaid, Private, Veteran's Administration contracts, and hospital contracts, etc. Behaves in a manner aligned with facility goals for occupancy and customer service. Informs the Admissions Director of obstacles or barriers to admitting residents and recommends solutions to such obstacles and barriers. Communicates with interdisciplinary team members timely regarding clinical needs such as equipment, medications, etc. for pending admissions. Demonstrates interpersonal relationship skills by developing and maintaining trust with coworkers. Speaks effectively with physicians when necessary to clarify medical information Participates in facility assessment activities as needed, such as carrying out duties assigned as part of a performance improvement committee. Collaborates with members of the interdisciplinary team, physicians, consultants, and community agencies to identify and resolve issues that improve the admissions process. Promotes teamwork, mutual respect, and effective communication. Participates in the facility's plan of correction response to an inspection survey and implements any follow-up as designated by the Administrator or Director of Nursing. Promotes safe work practices, safety rules, and accident prevention procedures to prevent employee injury and illness. Additional Tasks Treats all residents with dignity and respect. Promotes and protects all residents' rights. Establishes a culture of compliance by adhering to all facility policies and procedures. Complies with standards of business conduct, and state/federal regulations and guidelines. Follows appropriate safety and hygiene measures at all times to protect residents and themselves. Maintains confidentiality of protected health information, including verbal, written, and electronic communications. Reports noncompliance with policies, procedures, regulations, or breaches in confidentiality to appropriate personnel. Reports any retaliation or discrimination to HR or compliance officer. Reports any allegations of abuse, neglect, misappropriation of property, exploitation, or mistreatment of residents to supervisor and/or administrator. Protects residents from abuse, and cooperates with all investigations. Reports any occupational exposures to blood, body fluids, infectious materials, and/or hazardous chemicals in accordance with facility policy. Participates in all life safety and emergency drills and trainings. Fulfills responsibilities as assigned during implementation or activation of the facility's emergency plan. Reports work-related injuries and illnesses immediately to supervisor. Follows established infection control policies and procedures. As a condition of employment, completes all assigned training and skills competency. Personal Skills and Traits Desired/ Physical Requirements/Working Conditions Ability to read, write, speak and understand the English language. Must be a supportive team member, contribute to and be an example of team work. Ability to make independent decisions when circumstances warrant such action. Ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public. Must have patience, tact, and willingness to deal with difficult residents, family and staff. Must not pose a threat to the health and safety of other individuals in the workplace. Must be able to move intermittently throughout the workday. Meets general health requirements according to facility policy, including medical and physical exams and checking immunity status to various infectious diseases. Ability to work beyond normal working hours and on weekends and holidays when necessary. Ability to assist in evacuation of residents during emergency situations. Ability to bend, stoop, kneel, crouch, perform overhead lifting and perform other common physical movements as needed for the position. May be subject to falls, burns from equipment, and/or odors throughout the day; encounter reactions from dust, tobacco smoke, disinfectants, and other air contaminants. Subject to exposure to infectious waste, diseases and/or conditions which include AIDS, Coronavirus, Hepatitis B, and Tuberculosis. May be subject to hostile or emotional residents, family members, visitors or personnel. Works harmoniously with coworkers. Successfully follows oral and written instructions. Successfully relays information concerning any given situation. Willing to cope with the mental and emotional stress of the position. Communicates professionally and often with medical and nursing staff, and other departments. Willing to be called-back during emergency conditions. Works in office and throughout the facility. Willing to work to task completion in spite of frequent interruptions. Works beyond normal working hours and on weekends, holidays when necessary.
