Description
Job Title: Admissions Specialist
FLSA Classification: Exempt
Reports To: Admissions Coordinator
Job Family: Radix Recovery
POSITION SUMMARY:
The Admissions Specialist is responsible for overseeing and strategically managing the intake and admissions process from initial inquiry through program enrollment. This role serves as a primary point of accountability for admissions decisions that materially impact organizational operations, including revenue integrity, payer mix, capacity management, regulatory compliance, and client access to services.
The Admissions Specialist exercises independent judgment and discretion when evaluating prospective admissions, verifying eligibility, coordinating authorizations, resolving complex or ambiguous cases, and determining appropriate courses of action within established clinical, regulatory, and financial frameworks.
RESPONSIBILITIES:
Admissions Oversight and Decision-Making
- Direct and manage the full admissions lifecycle from initial contact through enrollment.
- Evaluate eligibility by analyzing clinical criteria, insurance coverage, authorizations, and organizational capacity.
- Exercise discretion in resolving complex admissions scenarios.
- Make recommendations that impact revenue realization, compliance exposure, and continuity of care.
Insurance, Financial, and Regulatory Impact
- Verify insurance eligibility, benefits, and authorizations.
- Identify admissions-related risks affecting reimbursement or audit exposure.
- Interpret and apply federal, state, and organizational requirements.
- Maintain accurate documentation supporting admissions decisions.
Client, Family, and Referral Engagement
- Provide expert guidance regarding treatment options, coverage, and costs.
- Serve as a resource to referral sources and insurance partners.
- Manage sensitive communications requiring discretion.
Collaboration and Operational Leadership
- Partner with leadership to align admissions with census and capacity goals.
- Communicate admissions trends, barriers, and risks.
- Maintain effective relationships with internal and external stakeholders.
Front Desk and Administrative Support (As Needed)
- Provide front desk or reception coverage only when operationally necessary.
- Front desk support is incidental and not the primary function of the role.
Compliance and Reporting
- Ensure compliance with HIPAA and applicable laws.
- Prepare and analyze admissions-related reports.
Workplace Maintenance: (all employees)
- Participate in maintaining a clean, well-organized, and efficiently supplied work environment, contributing to a positive atmosphere for both clients and staff.
- Observe and report any safety or maintenance issues promptly to ensure a safe and functional workplace.
Professional Conduct: (all employees)
- Interact with clients and colleagues in a respectful and empathetic manner, maintaining professional boundaries and a demeanor that fosters trust and rapport.
- Uphold the privacy and confidentiality of all client information in accordance with federal and state laws, actively reporting any concerns regarding privacy violations or policy breaches to supervisors.
Additional Responsibilities:
- Other duties as assigned consistent with the exempt nature of the role.
SUPERVISORY RESPONSIBILITIES AND DIRECT REPORTS:
None.
Requirements
REQUIREMENTS:
Qualifications:
- High school diploma or GED.
- Six months of related experience in healthcare, admissions, insurance, or financial services
Knowledge, Skills, and Abilities:
- Experience with healthcare revenue cycle or utilization review.
- Familiarity with medical terminology and behavioral health settings.
- Independent judgment on matters of significance.
- Strong analytical and decision-making skills.
- Knowledge of HIPAA and payer requirements.
- Proficiency with EHR systems and business software.
- Workplace Maintenance (all employees)
- Understanding health and safety regulations to ensure a secure environment for clients and staff.
- Professional Conduct (all employees)
- Compassionate client interaction with empathy and active listening.
- Maintenance of professional boundaries to ensure a safe therapeutic environment.
- Knowledge of federal, state, and municipal laws and regulations governing the treatment of alcoholism and drug addiction, including confidentiality, client rights, professional ethics, and anti-discrimination policies.
- Proficient in crisis communication, maintaining professionalism in high-stress situations.
- Additional Responsibilities
- If applicable…
Other Conditions:
- May require evenings, weekends, and holidays.
- Limited off-hours availability for time-sensitive admissions matters.
- Authorized to work in the U.S.
- Must be willing to travel as often as needed
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