Clinical Review Specialist

Pinnacle Home Care

Clinical Review Specialist reviewing home health orders and care plans for Pinnacle Home Care, a Florida-based home healthcare provider. Supporting compliant patient intake, welcome calls, documentation, and timely starts of care.

Posted 8/13/2026part-timeOldsmar • Florida • 🇺🇸 United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in home health intake processes, ensuring compliance with CMS guidelines and Medicare Conditions of Participation while maintaining accurate documentation in EMR systems. Exhibits strong communication and critical thinking skills to effectively triage patient needs and support care coordination.

Highest-signal resume keywords

Current LPN Or RN License2+ Years Clinical Experience In Home HealthKnowledge Of Medicare Conditions Of ParticipationProficiency With EMR SystemsExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Decision-MakingDocumentation AccuracyPatient OnboardingTriage SkillsRegulatory Compliance

Soft Skills

EmpathyTrust BuildingCritical ThinkingComposure Under Pressure

Tools & Technologies

EMR SystemsWellSkyMicrosoft Office SuiteOutlookTeamsExcel

Certifications & Qualifications

LPN LicenseRN License

Industry Keywords

Home Health RegulationsCMS GuidelinesIntake ProcessesCare CoordinationClinical Review

About the role

Key responsibilities & impact

Review all incoming home health orders for clinical appropriateness
Determine appropriate disciplines, frequencies, and visit types according to agency protocols and referral source requirements
Confirm compliance with CMS guidelines, Medicare Conditions of Participation, and internal agency standards
Take and accurately document verbal orders from physicians and referral sources
Perform patient welcome calls and support smooth onboarding
Triage and troubleshoot patient needs or concerns during intake conversations
Maintain a warm, empathetic, and professional phone presence
Document intake and order-related activities in the EMR
Ensure physician orders, care plans, and required documentation are complete, accurate, and properly uploaded
Maintain current knowledge of home health regulatory requirements
Follow daily reporting and tracking requirements
Partner with Intake, Care Coordination, and Branch leadership to ensure timely starts of care
Escalate clinical concerns or regulatory issues to the Clinical Review Manager
Support branch and central teams with troubleshooting and guidance on referral-related issues

Requirements

What you’ll need

Current LPN or RN with equivalent experience in home health intake or clinical review
2+ years of clinical experience in home health, intake, or care coordination
Knowledge of Medicare Conditions of Participation, CMS guidelines, and general home health regulations
Strong critical thinking and clinical decision-making skills
Excellent communication and phone skills
Ability to build trust with patients, referral sources, and colleagues
Proficiency with EMR systems; WellSky preferred
Proficiency with Microsoft Office Suite, including Outlook, Teams, and Excel
Ability to work in a fast-paced, high-volume environment with accuracy and composure
Availability for two weekends per month, Saturday and Sunday, 8:00 AM–6:30 PM Eastern Time

Benefits

Comp & perks

Free Continuing Education Units (CEUs) to support licensure and career advancement
Employee referral program where you can earn rewards
Flexible scheduling
Supportive and fun culture
Inclusive environment
Personalized, one-on-one care helping patients heal and regain independence
Growth and stability with over two decades as Florida’s largest independent home health agency
Recognized as a USA Today Top Workplace