Clinical Referral Coordinator (RN/LPN) (10297)

Summit Home Care and Hospice is searching for an experienced and motivated Clinical Referral Coordinator to join our team!  At Summit we’re committed to providing comprehensive healthcare services in the comfort of our patients' homes to positively impact quality of life by redefining the delivery of care.

Clinical Referral Coordinator:

• Hours: Monday - Friday; Standard Business Hours & Weekend/Holiday Rotation
• Pay Rate: $24.00 - $28.00 per Hour
• Location: 800 Yard St. Suite 300 Grandview Heights, OH 43212
• Work Setting: On-Site with Remote Opportunity After 6 Months

Responsibilities:

• Receive, review, and monitor new referrals to determine ability to accept or decline.
• Accurately determine and anticipate homecare needs and accept and decline on clinical appropriateness.
• Assists in interpreting operational indicators to detect census changes and increases or decreases in volume, which could impact staffing levels, revenues, or expenses.
• Adheres to the agency’s Acceptance to Service Policy.
• Collaborate with multiple teams, both internal and external, to ensure patient success in the homecare setting.
• Demonstrate professional assertiveness when communicating with external referral resources.
• Report and/or troubleshoots missing or incomplete documentation or visit notes needed for new admissions.
• Works with Authorizations and clinical management team when new insurances are identified to determine reimbursement, ability to bill and if new contract is needed.
• Call for, follow up on, track and obtain verbal orders for admissions.
• Fax written orders for signature for admissions when verbal order unable to be obtained.
• Ability to track, trend and maintain accept/decline reports.
• Ability to identify primary and secondary billable diagnosis.
• Understand and adhere to F2F requirement regulated by CMS.
• Ability to maintain Pre-Claim Review (PCR) of no less than 97% (While participating in PCR as an agency).
• Utilize office and other patient care software, including Microsoft Word, Excel, Adobe, and E- Fax.
• Maintain confidentiality of information related to patient and organization.
• Perform interdepartmental and external communication.
• Engage in team meetings and provide feedback.
• Develop and implement organization policies and procedures under guidance of supervisor(s).
• Attend in-person training and meetings when necessary.
• All other duties as assigned by supervisor(s).

Qualifications:  

• High school diploma required.
• Active Ohio nursing license required (LPN or RN).
• Must obtain an Indiana nursing license within 120 days (about 4 months) of employment.
• Ability to work independently or as an active member of a team.
• Strong computer skills in data entry, Microsoft Excel, and Word applications, must type 50 WPM.
• Strong attention to detail and problem-solving skills.
• Strong time management skills.
• Excellent verbal and written communication skills.
• Able to navigate multiple EMR systems (EPIC, Alis, Kinnser) for patient information with ease.
• Ability to multitask, prioritize, delegate, and handle constant changes in workflow.

Why Summit? 
We offer a well-rounded benefits package to support you both at work and at home. Full-time team members have access to medical, dental, and vision coverage, along with extras like life and disability insurance, FSAs/HSAs, telehealth services, and a 401(k) with company match. Part-time employees are also eligible for many of these great benefits. We also offer paid time off, six standard holidays each year plus a bonus day to celebrate your birthday, paid sick time, and free continuing education (CEUs) for full-time and part-time staff. To make your day-to-day easier, we also provide AI-assisted clinical documentation to help streamline charting and reduce administrative time.