What are the responsibilities and job description for the Clinical Reviewer position at The Macintosh Company Inc.?
Evaluates the medical condition of patients in hospital or at home to determine appropriate placement in a MacIntosh Facility based on level of care and insurance requirements.
Essential Job Duties & Responsibilities:
- Evaluate a patients clinical and insurance needs for appropriate placement into a MacIntosh facility
- Submit for insurance authorization as required by the plan type
- Document all necessary clinical information for admission and any special considerations.
- Communicate with the direct facility Administrator, DON or RT for special placements
- Work to maintain and exceed the corporate census goals
- Communicate with hospitals regarding placement in a professional and curious manor
- Request contracts for placement, this may include hospice or for CAPD as examples.
Required Skills/Abilities:
- Excellent verbal and written communication skills.
- Excellent interpersonal and customer service skills.
- Excellent organizational skills and attention to detail.
- Excellent time management skills with a proven ability to meet deadlines.
- Strong analytical and problem-solving skills.
- Ability to prioritize tasks and to delegate them when appropriate.
- Ability to function well in a high-paced and at times stressful environment.
- Proficient with many various computer systems not limited to CarePort, PCC, Outlook and others
Education and Experience:
- High school diploma or equivalent.
- At least two years related experience required in a skilled nursing facility setting.
- Registered Nurse or Licensed practical nurse degree or related clinical experience (must have no restrictions on license)
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