Utilization Review Specialist, RN

This is a fully remote position, open to applicants in Florida.

📋 Description

• Evaluate clinical documentation related to home health for accuracy and compliance.

• Conduct audits on OASIS documentation and care plans.

• Ensure the accuracy of coding and integrity of reimbursements.

• Collaborate effectively with Branch Directors, Clinical Managers, and field clinicians.

• Assist in initiatives for quality assurance and regulatory compliance.

• Maintain a high level of productivity while reviewing substantial volumes of documentation.

⛳️ Requirements

• Valid Florida RN License (unencumbered).

• OASIS Certification (mandatory).

• Coding Certification (mandatory).

• At least 2 years of experience in Home Health.

• Strong understanding of Medicare guidelines and home health regulations.

• Capability to work independently in a remote environment.

• Exceptional attention to detail and organizational abilities.

• Preferred experience with WellSky/Kinnser.

• Experience with the SHP platform.

• Previous experience in QA, Utilization Review, or Clinical Auditing.

🏝️ Benefits

• Medical, Dental & Vision Insurance.

• Life Insurance.

• 401(k).

• 3 Weeks Paid Time Off (PTO).

• Opportunities for Quarterly Bonuses.

• Employee Referral Program.

• Free Continuing Education Units (CEUs).

• Opportunities for Career Growth.