Clinical Reviewer & QA Specialist (RN or LPN)

Job Type Full-time Description Job Summary: **NOT REMOTE** - This position is IN OFFICE ONLY.  The Clinical Reviewer & Quality Assurance Specialist supports home health operations by reviewing incoming referrals, coordinating the intake process, and ensuring clinical documentation meets compliance and quality standards. This role plays a key part in ensuring accurate admissions, regulatory compliance, and continuity of patient care.  Essential Functions

• Review incoming referrals for completeness and clinical eligibility
• Verify required documentation (physician orders, face-to-face, clinical records)
• Identify missing information or compliance risks and follow up as needed
• Collaborate with intake, clinical teams, and referral sources to support timely admissions
• Assist with patient admissions and documentation tracking
• Ensure all required documents are obtained prior to Start of Care (SOC)
• Support insurance verification and authorization processes
• Communicate admission readiness with interdisciplinary teams
• Maintain timely referral processing to support patient care and agency growth
• Conduct QA audits on clinical documentation (SN, PT, OT, ST, CNA/HHA)
• Ensure documentation meets agency, regulatory, and payer standards
• Review for accuracy, completeness, and clinical appropriateness
• Identify trends and escalate documentation concerns
• Provide feedback to clinicians to improve documentation quality

• Active and current RN or LPN licensure
• Ability to critically review clinical records for accuracy and compliance.
• Proficient in EMR systems, preferably KanTime.
• Knowledge of home health and/or hospice regulations, including QAPI principles
• Valid driver’s license, reliable transportation, and current automobile insurance are required

• Health, dental and vision insurance
• 401(k) enrollment and employer contribution
• Paid time off and sick leave