Admission Nurse

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.

• 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.
• 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…