Chicago - Illinois (IL), 60644
Facilitates the patient inpatient and outpatient process which includes evaluation of the psychological, physiological and social conditions of potential patients to determine appropriate services and level of care. Manages communication with benefit providers in securing guarantees of reimbursements, completion of initial utilization review activities and oversees continued utilization review activities through the patients’ course of treatment. Develops and implements plans to increase ongoing and outgoing referral base.
ESSENTIAL DUTIES AND RESPONSIBILITIES
1. Evaluates patient’s symptoms to determine initial level of care required. This includes conducting assessments of incoming patients for evaluation of psychosocial dysfunctions, withdrawal symptoms, treatment and substance abuse history, etc according to ASAM criteria.
2. Develop preliminary treatment plan based on needs presented by patient in initial assessment. Communicates relevant client information to case managers and counselors.
3. Assists patients in completing admission paperwork including releases of information waivers concerning benefit providers, employers, courts, family and others relevant to patient’s care. Determine if patient’s insurance coverage is appropriate for services offered.
4. Acts as a liaison to business office, pre-certifies benefits, and provides verification of insurance coverage for traditional charges and extra patient charges.
5. Establishes ongoing communication with employers, referral sources and families of patients who are admitted or who are contemplating admission, including the facilitation of intervention, if indicated.
6. Conducts and reports initial/ utilization review to benefit providers and conducts utilization review activities throughout the patient’s course of treatment.
7. Offers and facilitates referrals to clients who do not meet admission criteria. Maintains statistics relevant to referral system. Continuously develops potential referral sources to meet patient’s ancillary and primary care needs and maintains referral log. Acts as a consultant to clinical staff in securing referral resources for their clients.
8. As member of the marketing team, assists in development and execution of marketing activities. Identifies sources of patient referral. Implements activities to promote referrals to and status of Addiction Center.
9. Answers hotline, giving general information about chemical dependency, providing crisis intervention and offer support and counseling to those who call. Responds to general inquiries concerning the activities and operation of the department by referring to the related policies and procedures.
10. Provides hospital wide consults to assess the needs of patients and participates in the multi-disciplinary staffing when requested.
11. Performs other related duties as assigned.
- High school diploma or GED equivalent. Bachelors of Arts in related field preferred.
- Certification as Assessment and Referral Specialist, CARS required, CADC, CSADC preferred.
- At least one year experience in the field of substance abuse, two years’ experience preferred.
- One year experience in health care marketing or other networking activities preferred.