Clinical PCC

Adaptive Home Health / Fira Health•Richardson, TX

1d•$58,000 - $65,000•Onsite

About The Position

Job Summary: We are seeking an experienced and detail-oriented Registered Nurse or Licensed Vocational Nurse to fill the Clinical Patient Coordinator role in order to manage the intake and approval process for new home health patients. This role requires clinical expertise, strong communication skills, and a thorough understanding of Medicare and commercial insurance eligibility guidelines. The Clinical Patient Coordinator will be responsible for ensuring that referred patients meet both clinical and insurance requirements before admission to home health services.

Requirements

Active RN or LVN license in Texas (Required)
2+ years of clinical nursing experience (Required).
Strong familiarity with Medicare and commercial insurance eligibility guidelines.
Exceptional attention to detail and ability to handle multiple tasks simultaneously.
Strong communication and team collaboration skills (working with intake, scheduling, and field teams).
Customer service-oriented mindset with a professional approach to patient interactions.

Nice To Haves

1-2 years of home health experience (Preferred).
Experience with OASIS documentation (Preferred but not required)
Proficiency in HCHB (Homecare Homebase) or similar EMR systems (Preferred)

Responsibilities

Clinical Approval & Review Review and approve patient referrals for home health eligibility based on medical necessity and regulatory guidelines.
Ensure patients meet eligibility requirements based on their diagnosis, medical history, and physician orders.
Verify insurance eligibility for Medicare and commercial insurance patients in Texas.
Collaborate with physicians, intake coordinators, patients and field staff to clarify orders and to ensure timely care.
Document approval decisions and communicate status updates to internal teams.
Ability to verify insurance requirements and obtain prior authorizations when needed is a plus
EMR Management & Oasis Familiarity with OASIS documentation requirements is a plus
Familiarity with Homecare Homebase EMR is a plus
Maintain accurate intake records to support smooth patient onboarding
Team Collaboration & Communication Work closely with intake coordinators, scheduling teams and field clinicians to ensure timely initiation of care
Communicate effectively with physicians, case managers / hospital discharge planners
Assist in streamlining workflows between intake, clinical and operational teams
Address patient inquiries and concerns with a professional and patient-centered approach