The Admissions Coordinator coordinates internal/external admissions and referrals and makes admission decisions utilizing established clinical criteria. This job is responsible for coordination of insurance authorizations and necessary pre-certification, re-certification, denial and appeal procedures to maximize reimbursement potential for clinical and medical services.
The Admissions Coordinator is responsible for educating and training physicians or medical residents, clinical staff and community professionals about the admissions processes and procedures. This role is also responsible for assuring a leadership role in interdisciplinary health care team and advocacy for quality patient care.
Licensure, Certification, or Registration Requirements for Hire:
Preferred License/Certification: Licensed Clinical Social Worker (LCSW), Licensed Clinical Psychologist (LCP), Licensed Professional Counselor (LPC), or Certification as a Case Manager (CCM), or Rehabilitation Counselor based on specialty area is preferred.
Licensure, Certification, or Registration Requirements for continued employment:
Current certification based on specialty area (e.g. LCSW, or LCP or LPC or CCM) preferred
Experience REQUIRED:
Minimum of three (3) years of previous work experience handling/negotiating cases with insurance companies based on area of specialty.
Experience PREFERRED:
Previous work experience with in-patient admissions and triage/clinical screening experience
Education/training REQUIRED:
Bachelor's Degree in Healthcare Administration, Social Science, an Allied Health field (e.g. Social Work, Nursing, Rehabilitation Counseling, etc.) or related field from an accredited program. A combination of education and experience may be considered in lieu of a degree.
Education/training PREFERRED:
Master's Degree in Healthcare Administration, Social Science or an Allied Health field (e.g. Social Work, Nursing, Rehabilitation Counseling, etc.) from an accredited program
Independent action(s) required:
Uses the hospital admissions criteria to make direct decisions regarding the appropriateness of patients for admission.
Handles all required insurance/managed care authorization and pre-certification functions for each admission scheduled and communicates relevant clinical information to the physicians and nursing staff prior to the admission of each patient.
Utilizes sound judgment in applying predetermined admission criteria, under clinical supervision.
Uses knowledge of patient's presenting problems, urgency of clinical need and expertise of the various providers to make appropriate decisions.
Utilizes his/her clinical expertise to serve as a crisis consultant as needed and provides clinical backup and support to non-clinical Patient Services Representatives in the performance of their scheduling duties.
Represents department on hospital committees or projects.
Coordinates marketing and community education planning and implementation of plans.
Supervisory responsibilities (if applicable):
Assists or provides leadership coverage in the absence of the Director to Inpatient Rehabilitation Services to maintain the smooth operation of the RRC.
Works closely with the Director in all areas of operations to ensure continuity of leadership in management of critical elements of the daily operations.
Additional position requirements:
This position works a traditional forty (40) hour week.
Occasionally, the position may be required to alternate schedules.
Age Specific groups served:
As appropriate based on unit assignment
Physical Requirements (includes use of assistance devices as appropriate):
Other: Exposure to potentially hazardous and infectious substances
Activities: Prolonged standing, Prolonged sitting, Walking (distance), Reaching (overhead, extensive, repetitive)
Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
Emotional: Fast pace environment, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent change Schedule: This is a traditional 40 hour work-week schedule. M-F 8-4:30pm. However, some weekends may be involved to facilitate family/community day. EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
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Virginia Commonwealth University Health Systems
May 19, 2025