Clinical Reviewer - Home Health

Jet Health, Inc is seeking an experienced Home Health Clinical Reviewer to be responsible for reviewing clinical documentation to ensure compliance with Medicare guidelines, company policies, and regulatory standards. This role supports quality improvement efforts by verifying the accuracy, completeness, and timeliness of documentation submitted by field clinicians. The Clinical Reviewer plays a critical role in maintaining the integrity of patient care records and ensuring timely reimbursement.

Key Responsibilities:

• Review OASIS assessments, Plan of Care, and clinical documentation for accuracy, consistency, and compliance.
• Validate appropriate ICD-10 coding and ensure documentation supports medical necessity and skilled services.
• Work closely with clinicians to provide education and feedback on documentation improvements and best practices.
• Monitor documentation for adherence to regulatory and payer-specific requirements (e.g., CMS, Medicare, Medicaid, private insurers).
• Ensure timely submission of documentation to support billing and avoid delays in reimbursement.
• Participate in quality assurance and performance improvement (QAPI) initiatives.
• Provide input and support for internal audits, surveys, and compliance reviews.
• Collaborate with intake, billing, and clinical management teams to resolve documentation-related issues.

• Registered Nurse (RN) or Licensed Practical Nurse (LPN) with an active and unrestricted license (RN preferred).
• Minimum 2 years of clinical experience in home health or a related healthcare setting.
• Experience with OASIS and Medicare home health regulations required.
• Familiarity with electronic medical records (EMR) systems; experience with systems like Homecare Homebase, WellSky (Kinnser), or MatrixCare is a plus.
• Detail-oriented with strong analytical and critical thinking skills.
• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team in a fast-paced environment.

Preferred Qualifications:

• Certified Oasis Specialist – Clinical (COS-C) or other relevant certification.
• Previous experience in quality assurance, utilization review, or compliance in home health.

Benefits for full time employees:

• Medical, Dental, and Vision insurance coverage
• Short- and Long-Term Disability insurance
• Accident, Critical Illness, and Cancer Insurance
• PTO - 80 hours after 60 days
• 6 paid holidays and 1 floating holiday
• 401k retirement savings plan w/discretionary company match
• Company-paid life insurance
• Mileage reimbursement
• Competitive compensation package