Admissions Nurse

Job Title: Admissions Nurse

Location: Skilled Nursing

Department: Nursing

Reports to: Unit Manager/ADON

FLSA Status: Non-Exempt

Position Summary:

We are seeking a licensed LPN or RN to support our admissions process by providing clinical review and coordination for prospective residents. This position plays an important role in reviewing referrals, medical information, medications, diagnoses, physician orders, and payer requirements to help determine whether the facility can safely and appropriately meet a resident’s needs. The Clinical Admissions Nurse works closely with the Admissions Director, Director of Nursing, physicians, referral sources, Business Office, and interdisciplinary team to ensure a smooth and timely admissions process.

The ideal candidate is organized, clinically knowledgeable, detail-oriented, and comfortable communicating with healthcare professionals while balancing resident needs, regulatory requirements, and facility capabilities.

• 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…