Clinical Support Specialist

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).

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  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

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  Assist with order tracking, including 485 as needed to include sending, tracking and follow up

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  Assists with Face to Face gathering and tracking and other physician verification processes as requested

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  Assists with care coordination and documentation

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  Keeps current on all clinical compliance information and can apply/teach that knowledge consistently

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  Reports any clinical compliance or billing issues that affect outcomes and/or reimbursement to supervisor

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  Discusses clinical questions and provides education directly with field staff during the review process (phone/email/through EMR)

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  Recognizes the need for a high degree of accuracy and educates field staff to deficiencies

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  Attends in-services and continuing education as applicable

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  Functions as member of committees for the position as assigned and applicable

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  Attains goals as set forth in annual performance evaluation and the corporate compliance goals

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  Submits documentation within required timeframes

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  Maintains strict confidentiality on patient, agency, and employee matters

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  Assists with quarterly PI process as requested

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  Performs other duties as assigned

• 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

• Minimum of one (1) year of experience in home health (preferred)

• Active Nursing License required. Maintains licensure requirements as applicable to the position/state

“You are not required to disclose information about physical or mental limitations that you believe will not interfere with your ability to do the job.  However, you should disclose any physical or mental impairment for which special arrangements or accommodations are needed to enable you to perform the essential functions of the job. Your description of any impairment and suggestions for reasonable accommodations will be considered in providing reasonable accommodations.”

• Requires the ability to write, dictate or use a keyboard to communicate directives.

• Utilizes proper body mechanics in multiple environments.

• Requires the ability to function in multiple environments.

FLSA Status:  Non-Exempt

EEO Status:  Administrative Support Workers