Admissions Specialist at Abarca Health

Mitchell, South Dakota, United States

Apply Now

Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

Healthcare, HospitalIndustries

Requirements

Ability to work rotating shifts: 3:00pm-11:00pm, occasional 11:30am-8:00pm, every other weekend, and overnight 11pm-7:00am
Visual acuity adequate to perform position duties
Ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds
Knowledge, skills, and abilities to perform essential job functions (reasonable accommodations may be made for disabilities without undue hardship)

Responsibilities

Register patients in a timely and accurate manner by entering demographic, insurance, physician, and other defined information while following established registration standards
Assist Patient Care staff with bed assignments based on patients' diagnosis, age, and condition
Monitor the quality and efficiency of the registration process, including completing follow-up on incomplete registrations through bedside registration
Generate patient estimates, educate patients on their plan benefits at the time of service or pre-calling, and identify specific account goals for collection based on deposit matrix/patient estimator tools
Request and accept deposits towards deductible and/or coinsurance amounts from patients based on current deposit matrix/patient estimator tools and post payments correctly to the payment processing system
Verify insurance coverage and limitations, and collect patient co-payments, deductibles, and out-of-pocket expenses; communicate this to the patient
Complete insurance verifications, pre-certification, and/or authorization for assigned accounts
Maintain positive customer relations as evidenced by feedback from patients, visitors, physicians, patient care units, and fellow employees
Ensure all patients are offered a Patient’s Rights Brochure, understand the admission consent form, and are informed of the hospital’s privacy practices (HIPAA)
Coordinate internal hospital messages, import continuity of care documents (CCDs), and answer telephone promptly and courteously, immediately addressing caller’s needs
Interact with patients in Patient Care units to complete registration, obtaining consents, informing patients of telephone consumer protection act, insurance information, referring physicians, and CMS required documentation (e.g., IMMs, MOON, OBVs)
Check for medical necessity by confirming CPOM order and status of care at time of admission for direct admits
Perform all necessary procedures to create accounts/medical record numbers and coordinate communication with patients, employees, providers, and external financial agencies

Skills

Key technologies and capabilities for this role

Patient RegistrationInsurance VerificationPatient DemographicsBed AssignmentPoint of Care CollectionPre-certificationAuthorizationCustomer Service

Questions & Answers

Common questions about this position

What is the pay range for the Admissions Specialist position?

The pay range is $17.75 - $22.75, with actual pay rate dependent upon experience.

Is this a remote position or does it require on-site work?

This is an on-site position at Avera Queen of Peace Hospital with rotating shifts including days, evenings, nights, weekends, and holidays.

What are the main responsibilities of the Admissions Specialist?

The role involves registering patients accurately, verifying insurance coverage, collecting payments, completing pre-certifications, and maintaining positive customer relations.

What is the team environment like at Avera?

You will be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for patients.

What shift schedule should I expect for this role?

The primary shift is 3:00pm-11:00pm with occasional 11:30am-8:00pm, every other weekend, and overnight shifts from 11pm-7:00am.

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

Land your dream remote job 3x faster with AI

Try Jobo Free