LPN – Clinical Intake Specialist

Partners in Home Care•Missoula, MT

2d•Hybrid

About The Position

Partners In Home Care (PIHC) is seeking an LPN Clinical Intake Specialist to join their Quality Assurance team in Missoula, Montana. This new role is designed to enhance support for community providers, improve the patient experience, and ensure compliance with regulatory standards. The LPN will act as a clinical expert within the Intake team, building relationships with referral sources and providing clinical guidance on complex cases and compliance issues. This position is crucial for maintaining PIHC's high standards of care and ensuring patients are well-supported from admission.

Requirements

Active Licensed Practical Nurse (LPN) license in Montana (or ability to obtain prior to start date)
Minimum 2 years of clinical experience (Home Health, Hospice, hospital, SNF, or case management preferred)
Knowledge of Medicare Home Health and Hospice eligibility criteria
Strong clinical documentation skills
Understanding of medical terminology
Excellent interpersonal and customer service skills
Comfort with in-person outreach and relationship development

Nice To Haves

Prior intake or authorization experience in Home Health or Hospice
Experience reviewing Face-to-Face encounter documentation for Medicare compliance
Familiarity with Home Care Home Base (HCHB) EMR; Epic or Cerner experience also valued
Knowledge of PDGM (Home Health)
Knowledge of Hospice Conditions of Participation
ICD-10 Coding knowledge and/or certification
Established relationships with Missoula-area referral sources or healthcare community

Responsibilities

Build and maintain relationships with referral sources (hospitals, clinics, physician offices) through in-person visits.
Communicate proactively with referral sources regarding admission timelines, documentation needs, and service capabilities.
Educate referral sources on Home Health and Hospice eligibility, documentation requirements, and patient pathways.
Review Face-to-Face (F2F) encounter notes for Medicare and payer compliance, including provider signature, date, timeframes, homebound status/terminal prognosis, and medical necessity.
Identify and resolve incomplete or non-compliant documentation with providers.
Monitor outstanding F2Fs and escalate proactively to prevent care gaps.
Apply clinical judgment to assess referral appropriateness before admission.
Serve as a clinical resource for the Intake team, answering questions, guiding eligibility decisions, and triaging complex referrals.
Receive, process, and track incoming Home Health and Hospice referrals from receipt through admission.
Verify patient demographics, insurance coverage, and payer criteria.
Ensure referral documentation is complete before admission.
Communicate admission readiness to clinical managers and coordinate start-of-care timing.
Enter and maintain accurate referral and patient data in the EMR.
Uphold metrics and standards to ensure patients are fully supported.
Serve as a clinical bridge between Quality and Intake teams, bringing a clinical lens to intake workflows.
Identify patterns that inform quality improvement.
Participate in audits, quality reviews, and process improvement initiatives.
Identify trends in documentation deficiencies and share findings with the Quality team.
Support compliance with Medicare/Medicaid, accreditation standards, and HIPAA requirements.
Perform other duties as assigned.