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Clinical Review Specialist - LPN
This job is now closed
Job Description
- Req#: CLINI010278
Employer Industry: Home Health Care
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits including Daily Pay (work today, get paid tomorrow!)
- Free Continuing Education Units (CEUs) to support licensure and career development
- Flexible scheduling to accommodate personal priorities
- Supportive and collaborative work environment
- Recognized as a USA Today Top Workplace
What to Expect (Job Responsibilities):
- Review new patient referrals for medical necessity and compliance with payer and regulatory requirements
- Verify Face-to-Face (F2F) encounter documentation for accuracy and compliance
- Collaborate with clinical and operational leadership to ensure effective care delivery
- Monitor referral documentation and care plans to prevent financial risks and denials
- Maintain knowledge of regulations impacting home health and ensure compliance with standards
What is Required (Qualifications):
- Active, unrestricted LPN license in the state(s) served
- Minimum 2 years of recent experience in home health clinical practice, utilization review, or compliance auditing
- Strong knowledge of home health regulations and payer requirements
- Excellent analytical, compliance, and problem-solving skills
- Effective communication and interpersonal skills with physicians, staff, and payers
How to Stand Out (Preferred Qualifications):
- Demonstrated ability to balance clinical decision-making with fiscal stewardship
- Detail-oriented with a focus on accurate, compliant documentation
- Strong organizational skills with the ability to prioritize and manage multiple tasks
- Ability to work independently while collaborating with interdisciplinary teams
#HomeHealthCare #ClinicalReview #CareerOpportunity #ContinuingEducation #FlexibleScheduling
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