Clinical Documentation Review Specialist

Pennant Services

1d • Remote

About The Position

The Clinical Documentation Review Specialist plays a crucial role in ensuring the accuracy of clinical documentation companywide. This position involves collaborating with team members and clinical leaders to identify inadequate documentation and assist in the provision of education to improve documentation, ensuring compliance with regulatory requirements and optimizing reimbursement processes. The ideal candidate has strong clinical knowledge of both Home Health and Hospice, excellent communication skills, and a keen eye for detail.

Requirements

• Registered Nurse or related licensure highly preferred.
• Significant experience and knowledge of Home Health, and/or Hospice environment, typically gained by five or more years of industry-related experience.
• Knowledge of Medicare and Medicaid Regulations.
• Strong sense of autonomy and confidence when working independently but will also be a team player.
• Demonstrates initiative in researching and resolving issues.
• Able to discern areas in need of continued improvement.
• Detail and deadline oriented with the ability to prioritize and multitask.
• Able to adapt to a fast-paced environment and learn and retain new or evolving information and procedures.
• Able to collaborate with physicians and healthcare providers to clarify clinical documentation and obtain additional information when necessary.
• Flexible and responsive to changing business needs.

Responsibilities

• Conduct detailed home health and hospice pre-billing reviews to support Portfolio partners and their agencies.
• Identify discrepancies, missing information, and opportunities for documentation improvement.
• Utilize information gathered to provide education and facilitate alterations to the HCHB documentation, and process improvements to prevent recurrence.
• Direct agencies to use documentation data outcomes for QA improvements.
• Ensure documentation accurately reflects the patient’s clinical status and the care provided.
• Set up meetings with clinical leaders to provide education, highlight findings, and make documentation recommendations.
• Stay current with practices in both home health and hospice fields and suggest educational and resource materials which would be beneficial to the staff.
• Recommend new approaches to on-going continued improvements to policies, procedures, and documentation.
• Identify trending issues and share them with the team and the clinical leaders.
• Stay up to date with all federal, state, and local regulations, as well as organizational policies and procedures to ensure compliance.
• Work within and be comfortable with HCHB, PDF-Xchange, Excel, and Smartsheet.
• Consistently promote CAPLICO

Benefits

• Choice of medical, dental and vision plans
• Retirement savings opportunities through a 401(k)
• Company match
• Various other features
• Recognition through our Moments of Truth Program
• Free e-courses through our Learning Management System
• Training sessions and seminars

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed