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Clinical Review Specialist – LPN
Pinnacle Home CareClinical Review Specialist ensuring clinical excellence and regulatory compliance in home healthcare services. Join Pinnacle in delivering compassionate care where it matters most.
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