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Clinical Review Specialist – LPN
Pinnacle Home Care. Review all incoming home health orders for clinical appropriateness .
About the role
Key responsibilities & impact- Review all incoming home health orders for clinical appropriateness
- Determine appropriate disciplines, frequencies, and visit types in line with agency protocols and referral source requirements
- Confirm compliance with CMS guidelines, Medicare Conditions of Participation (COPs), and internal agency standards
- Take and document verbal orders from physicians and referral sources accurately and efficiently
- Perform patient welcome calls to ensure a smooth, positive onboarding experience
- Triage and troubleshoot patient needs or concerns during intake conversations
- Maintain a warm, empathetic, and professional phone presence to reassure patients and referral partners
- Accurately document all intake and order-related activities in the EMR (WellSky/KanTime or similar)
- Ensure physician orders, care plans, and required documentation are completed, accurate, and properly uploaded
- Maintain an up-to-date understanding of home health regulatory requirements, including Medicare, CMS, and state guidelines
- Partner closely with Intake, Care Coordination, and Branch leadership to ensure timely patient starts of care
Requirements
What you’ll need- Current LPN with equivalent experience in home health intake/clinical review
- 2+ years of clinical experience in home health, intake, or care coordination
- Knowledge of Medicare COPs, CMS guidelines, and general home health regulations
- Strong critical thinking and clinical decision-making skills
- Proficiency with EMR systems (WellSky/KanTime preferred) and Microsoft Office Suite (Outlook, Teams, Excel)
- Ability to work in a fast-paced, high-volume environment with accuracy and composure.
Benefits
Comp & perks- Free Continuing Education Units (CEUs) to support licensure and career advancement
- Competitive Benefits & Perks including an employee referral program where you can earn rewards
- Ongoing Professional Development
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical reviewpatient intakedocumentationcritical thinkingclinical decision-making
Soft Skills
empathycommunicationorganizationproblem-solvingcomposure
Certifications
LPN