Clinical Reimbursement Operations Specialist

4 weeks ago

Radnor Twp, United States Main Line Health Full time

About Main Line Health

Main Line Health is a leading healthcare provider in the region, committed to delivering exceptional patient care and service. Our team of dedicated professionals is passionate about making a difference in the lives of our patients and their families.

Job Summary

We are seeking a skilled Clinical Reimbursement Operations Specialist to join our team. This role will be responsible for overseeing and evaluating the services provided to home health clients to maximize clinical outcomes, financial profitability, and regulatory compliance.

Responsibilities

  • Review all clinical assessment (OASIS) documentation and assess appropriate visit utilization patterns based on the care needs of the client and the reimbursement to be received by the agency for providing this care.
  • Make decisions by reviewing the gross profit margin of each client taken under care and the ability of the client/caregiver to support care in the home.
  • Ensure the proper ICD-10 coding and sequencing of the diagnoses for the claim.
  • Oversee the progress of the client during the home health episode of care and monitor care events that may trigger a change in care needs.
  • Review and sign all plans of care (Medicare form-485 orders) and service orders going to physicians.

Requirements

  • Three to five years of clinical experience with at least two years of home care experience preferred.
  • Basic computer skills required, knowledge of home health information system a plus.
  • Knowledge of Medicare regulations pertaining to Home Health, expertise in Home Health Coding preferred.
  • Graduate of an accredited School of Nursing required.
  • Current licensure in the Commonwealth of Pennsylvania as a Registered Nurse required.

Benefits

  • Competitive salary range: $40.00 - $40.00 per hour.
  • Employee discounts to various activities, services, and vendors.
  • Free employee parking.

What We Offer

  • An exciting opportunity to join a dynamic team of healthcare professionals.
  • A comprehensive benefits package, including health, dental, and vision insurance.
  • Opportunities for professional growth and development.

How to Apply

If you are a motivated and detail-oriented individual who is passionate about delivering exceptional patient care, please submit your application, including your resume and a cover letter, to our online portal. We look forward to hearing from you

  • Physical Therapist

    1 month ago

    Radnor Twp, United States CoreMedical Group Full time

    **Job Opportunity for Physical Therapist**We are seeking a skilled Physical Therapist to join our team at CoreMedical Group. This is a travel allied professional opportunity for a PT to work in an outpatient clinic setting.Key Responsibilities:Provide physical therapy services to patients in an outpatient clinic settingDevelop and implement individualized...

  • Sr Clinical Manager Ambulatory RN

    3 weeks ago

    Radnor Twp, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Clinical Manager Ambulatory RN

    3 weeks ago

    Radnor Twp, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Sr Clinical Manager Ambulatory RN

    3 weeks ago

    Radnor Twp, United States Penn Medicine Full time

    Description Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today...

  • Sr Clinical Manager Ambulatory RN

    3 weeks ago

    Radnor Twp, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Inventory Control Specialist

    1 day ago

    Radnor Twp, United States Phoenix Global Corporation Full time

    Job SummaryWe are seeking an experienced Inventory Control Specialist to join our team at Phoenix Global Corporation in East Chicago, IN. This full-time position involves managing inventory levels, tracking stock movements, and maintaining accurate records.Key Responsibilities:Manage inventory levels to ensure optimal stock balances and minimize wasteTrack...

  • PT - Physical Therapist - Outpatient/Clinic

    1 month ago

    Radnor Twp, United States CoreMedical Group Full time

    Job Details Physical Therapist needed for a location in Radnor, PA. CoreMedical Group has hundreds of exciting and rewarding travel assignments throughout the country for Travel Allied Professionals and Travel Nurses. Our clients are among the most prestigious healthcare facilities in the country. As a travel allied professional or a traveling nurse with...

  • Registered Nurse, RN

    4 weeks ago

    Radnor Twp, United States Main Line Health Full time

    Could you be our next Per Diem Transfer Center Registered Nurse (RN) at our Virtual Care Operation Center located in Radnor, PA? Why work as a Transfer Center Nurse with Main Line Health? Make an Impact! Come be a part of our newly established team at our Virtual Care Operation Center (VCOC) located at Radnor, PA! In your role as a VCOC Nurse, you will...

  • Staff Nurse, RN

    1 month ago

    Radnor Twp, United States Main Line Health Full time

    Description - External Could you be our next Transfer Center Registered Nurse (RN) at our Care Operation Center located in Radnor, PA? Why work as a Transfer Center Nurse within Main Line Health? Make an Impact! Come be a part of our team at our Care Operation Center (VCOC) located at Radnor, PA! In your role as a Transfer Center Nurse, you will coordinate...

  • Nurse Specialist

    4 weeks ago

    Radnor Twp, United States Main Line Health Full time

    Make a Difference in Home CareMain Line Health is seeking a skilled Registered Nurse to join our Home Care team. As a Home Care Nurse, you will provide coordinated, comprehensive nursing care to patients in the comfort of their own homes.Key Responsibilities:Use your critical thinking and clinical judgment skills to deliver high-quality patient care.Develop...

  • Senior Physician Liaison

    3 weeks ago

    Radnor Twp, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Senior Physician Liaison

    3 weeks ago

    Radnor Twp, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Sr Clinical Manager Ambulatory RN

    1 week ago

    Radnor, United States Penn Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Client Service Specialist

    6 months ago

    Radnor, United States Mercer Advisors Full time

    Mercer Advisors is a different kind of wealth management firm. We exist so that our clients don’t have to worry about money. Our firm was founded in 1985, on the belief that families at all wealth levels would benefit from a fully unified approach to managing their money – “A family office for your family.” We connect the dots of our clients’...

  • Sr Clinical Manager Ambulatory RN

    3 weeks ago

    Radnor, United States Penn Medicine Full time

    **Description** Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all...

  • Sr Clinical Manager Ambulatory RN

    3 days ago

    Radnor, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn...

  • Sr Clinical Manager Ambulatory RN

    1 week ago

    Radnor, United States Pennsylvania Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn...

  • Physical Therapist, Home Care

    4 weeks ago

    Radnor Twp, United States Main Line Health Full time

    Description: Could you be our next Physical Therapist within Main Line Health HomeCare? This dynamic home care clinician would be making an impact with patients and their families in the Gladwyne, Wynnewood, Narberth, Ardmore, Haverford, Bryn Mawr, Villanova area. Why work as a Home Care Physical Therapist with Main Line Health?Make an Impact! You are a key...

  • Sr Clinical Manager Ambulatory RN

    1 week ago

    Radnor, United States Penn Medicine Full time

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...

  • Physical Therapist, Home Care

    3 weeks ago

    Radnor Twp, United States Main Line Health Full time

    Description: Could you be our next Physical Therapist within Main Line Health HomeCare? This dynamic home care clinician would be making an impact with patients and their families in the Gladwyne, Wynnewood, Narberth, Ardmore, Haverford, Bryn Mawr, Villanova area. Why work as a Home Care Physical Therapist with Main Line Health?Make an Impact! You are a key...