The Clinical Support Specialist (CSS) is a qualified licensed professional nurse. The CSS is responsible for supporting the clinical operations and tasks in an assigned office/market/state. The CSS functions within state, federal and accreditation guidelines. In this role, you will report to the Director of Nursing (DON)/Director of Patient Care Services (DPCS)/Clinical Supervisor (CS).
Duties/Responsibilities:
Completes Quality Assurance Audits of medical records to include daily visit/shift notes and OASIS documents as applicable, to ensure proper and accurate documentation to maximize reimbursement and compliance through looking for appropriate documentation, medical necessity visit utilization, adherence to the care plan, care coordination and any other documentation applicable
Assist with order tracking, including 485 as needed to include sending, tracking and follow up
Assists with Face to Face gathering and tracking and other physician verification processes as requested
Assists with care coordination and documentation
Keeps current on all clinical compliance information and can apply/teach that knowledge consistently
Reports any clinical compliance or billing issues that affect outcomes and/or reimbursement to supervisor
Discusses clinical questions and provides education directly with field staff during the review process (phone/email/through EMR)
Recognizes the need for a high degree of accuracy and educates field staff to deficiencies
Attends in-services and continuing education as applicable
Functions as member of committees for the position as assigned and applicable
Attains goals as set forth in annual performance evaluation and the corporate compliance goals
Submits documentation within required timeframes
Maintains strict confidentiality on patient, agency, and employee matters
Assists with quarterly PI process as requested
Performs other duties as assigned
Required Skills/Abilities/Knowledge:
Knowledgeable on computer system to include back office and device versions and can educate on the systems as needed and requested
Excellent verbal, written and computer communication skills
Excellent organization, time management and problem-solving skills
Able to work and communicate well with multiple teams within the organization to promote viable, ethical, and cost-effective solutions. Able to effect buy-in from multiple levels of authority
Able to effectively deal with change
Able to complete projects within specific timetables
Ability to work in all computer systems being utilized
Excellent knowledge of processes or ability to learn and implement
Ability to be well organized and prepared
Excellent attendance and ability to deal with teammates in an acceptable manner to further the goals of the team
Understands HIPAA guidelines
Requires the ability to use logical and scientific thinking to interpret technical data and solve a broad range of problems including the ability to use complex techniques to assess situations
Requires the ability to interpret, adapt and react calmly under stressful conditions
Must be able to relate cooperatively and constructively with clients and co-workers and effectively monitor and develop the abilities of subordinates
Requires the ability to communicate verbally and in writing and to maintain confidentiality of sensitive information
Must display strong leadership skills under all circumstances
Education/Experience/Licenses/Certifications:
Minimum of one (1) year of experience in home health (preferred)
Active Nursing License required. Maintains licensure requirements as applicable to the position/state
Medical, Dental, and Vision Insurance
Paid Time Off and Paid Sick Time
401(k)
Referral Program
Pay Range: $25.00 - $35.00 / hour
Team Select Home Care reserves the right to change the above job description and qualifications without notice. Team Select Home Care will not discriminate against you on the basis of race, color, religion, national origin, sex, sexual preference, disability, political belief, veteran status, age, or any other status protected by law. Team Select Home Care is an employment-at-will employer.