Due Diligence Clinical Reviewer

Job Summary

A company is looking for a Due Diligence Clinical Review Specialist.

Key Responsibilities

• Perform due diligence clinical reviews for home health and hospice acquisitions, ensuring compliance with regulations
• Identify risks affecting reimbursement, compliance, and clinical outcomes, and provide actionable recommendations
• Develop and deliver education and training on documentation best practices and regulatory requirements

Required Qualifications

• Minimum 5 years of experience in Home Health and/or Hospice with knowledge of CMS Conditions of Payment and Participation
• Prior experience with due diligence, compliance, or audit review processes preferred
• Proficiency in multiple EMRs, including experience with HCHB
• Strong ability to interpret data analytics and prepare trending reports
• Demonstrated ability to work independently and meet deadlines in a fast-paced environment