Clinical Review Specialist -LPN

Job description

Are you looking to make a difference in patients’ lives with a company that values your expertise? Join us in our mission of delivering compassionate healthcare where it matters most –– at home. Pinnacle Home Care Holdings, LLC ("Pinnacle") is a leading Florida-based provider of home healthcare services. We're seeking an experienced Clinical Review Specialist to join our growing team and ensure every patient's care plan starts with clinical excellence, regulatory compliance, and a compassionate touch. Key Responsibilities: - 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...