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.
Duties and 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
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
Qualifications
Minimum 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.
Additional Information
We are committed to providing a competitive Total Rewards Package that meets our employee’s needs.
From a choice of medical, dental and vision plans to retirement savings opportunities through a 401(k), company match and various other features, we offer a comprehensive benefits package. We believe in great work and we celebrate our employees' efforts and accomplishments both locally and companywide, recognizing people daily through our Moments of Truth Program. In addition to recognition, we believe in supporting our employees' professional growth and development. We provide employees a wide range of free e-courses through our Learning Management System as well as training sessions and seminars.
Compensation: Based on experience.
Type: Full Time
Location: Remote
If interested in this position, please submit a resume for consideration. We look forward to hearing from you!
About The Pennant Group
We are proud to be affiliated with the Pennant Group, Inc. (NASDAQ: PNTG). Pennant was created in 2019 in connection with The Ensign Group, Inc.’s (NASDAQ: ENSG) spin-off of its home health, hospice, and senior living businesses. We believe that through our innovative operating model, we can foster a new level of patient care and professional competence at our independent operating subsidiaries and set a new industry standard for quality home health and hospice and senior living services. You can learn more about The Pennant Group at www.pennantgroup.com
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.