Clinical Support Specialist

Team Select Home Care•Denver, CO

About The Position

The Clinical Support Specialist (CSS) is a qualified licensed professional nurse who supports clinical operations and tasks in an assigned office, market, or state. The role operates within applicable state, federal, and accreditation guidelines and reports to the Director of Nursing (DON), Director of Patient Care Services (DPCS), or Clinical Supervisor (CS). The CSS reviews clinical documentation and supports compliance, care coordination, reimbursement, and education for field staff. The position requires an active nursing license and the ability to maintain applicable licensure requirements. One year of home health experience is preferred.

Requirements

Active nursing license; maintain licensure requirements applicable to the position and state.
Knowledge of computer systems, including back-office and device versions, with ability to educate others on systems as needed.
Excellent verbal, written, and computer communication skills.
Excellent organization, time-management, and problem-solving skills.
Ability to work and communicate effectively with multiple teams to promote viable, ethical, and cost-effective solutions.
Ability to gain buy-in from multiple levels of authority.
Ability to adapt to change and complete projects within specific timetables.
Ability to work in all computer systems used by the organization.
Excellent knowledge of processes, or ability to learn and implement them.
Ability to be organized and prepared, maintain excellent attendance, and interact acceptably with teammates to further team goals.
Understanding of HIPAA guidelines.
Ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems, including using complex techniques to assess situations.
Ability to interpret, adapt, and react calmly under stressful conditions.
Ability to relate cooperatively and constructively with clients and co-workers and effectively monitor and develop subordinates' abilities.
Ability to communicate verbally and in writing and maintain confidentiality of sensitive information.
Strong leadership skills under all circumstances.
Ability to write, dictate, or use a keyboard to communicate directives.
Ability to use proper body mechanics and function in multiple environments.

Nice To Haves

One year of home health experience is preferred.

Responsibilities

Complete quality assurance audits of medical records, including daily visit or shift notes and OASIS documents as applicable, to support accurate documentation, reimbursement, and compliance.
Review documentation for medical necessity and visit utilization, adherence to the care plan, care coordination, and other applicable requirements.
Assist with order tracking, including Form 485 orders, and send, track, and follow up as needed.
Assist with gathering and tracking Face-to-Face documentation and other physician verification processes as requested.
Assist with care coordination and documentation.
Stay current on clinical compliance information and consistently apply and teach that knowledge.
Report clinical compliance or billing issues that affect outcomes or reimbursement to a supervisor.
Discuss clinical questions with field staff and provide education during the review process by phone, email, or through the EMR.
Identify the need for accurate documentation and educate field staff about deficiencies.
Attend applicable in-services and continuing education.
Serve on committees as assigned and applicable to the position.
Meet goals set in the annual performance evaluation and corporate compliance goals.
Submit documentation within required timeframes.
Maintain strict confidentiality regarding patient, agency, and employee matters.
Assist with the quarterly PI process as requested.
Perform other duties as assigned.