Clinical Reviewer (RN)
AngMar Management Services
Why Choose AngMar Management Services?
AngMar Management Services owns and operates Angels Care Home Health & Hospice, which has nearly 100 offices located throughout the United States. Over the past 20+ years, we have grown to be one of the largest national Home Health Care Providers.
AngMar Management Services is Nationally Recognized as a ‘Great Place to Work’!
What we offer:
Generous Paid Time Off The flexibility of our PTO plan allows you to set your own priorities & use it for any number of events in your life. Extensive Training We encourage you to continue your professional development. Angels Care offers access to CEU portals at zero cost to you. Full Health, Dental, & Vision Benefits (Available 1st Month) We offer comprehensive & competitive medical and dental benefits. There are multiple options for you to choose from so you can select a plan that works best for you. Company Matched 401(k) We care about your financial well-being and help contribute & plan for your future retirement goals. Career Advancement Angels Care has an ‘Internal Promotion’ first mentality. We want you to grow your career with us!Job Summary:
The primary function of the Clinical Reviewer is to manage and process electronic medical record documentation via HCHB software system. You will also communicate any education needs or documentation concerns to the DON and/or office Administrator in support of and for home health companies managed by the employer.
Functions:
Demonstrates in-depth knowledge of EMR privacy and confidentiality rules and regulations and adheres to HIPAA requirements, local, state and federal guidelines. Works under the direction of the Clinical Supervisor for field staff documentation reviews and education needs, as indicated. Performs adequate audit of clinical records, including OASIS documentation and quality/accuracy of orders; education as needed to individual clinicians. Ensure Medical Necessity and Homebound Status criteria are met through documentation. Communicates with DONs and branch-level management concerning field staff educational needs. Review proposed 485 edits and enter coding reconsideration notes, as necessary. Works with coding personnel and liaisons to obtain needed items to support coding. Review/Edit/Approve F2F encounter and follow up on invalid F2F Encounter Date. Review/Edit/Approve Home Health Aide Care Plan and appropriate follow up if required. Review/Edit/Approve physician orders including Add-On orders and ROC orders. Perform after hours and on-call duties or visits as assigned.Qualifications:
Graduate of an accredited Diploma, Associate, or Baccalaureate School of Nursing. Two years of experience in home care. Current state license as a Registered Nurse (RN). Current state Driver’s License. Proof of CPR and Hepatitis profile. Valid auto liability insurance.
We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.