RN / REGISTERED NURSE - HOME HEALTH - CLINICAL REFERRAL PROCESSOR

Annapath • Full-time • Millsboro, DE, US • $73.11k - $113.32k / year • 1h ago

Overview

The Clinical Referral Processor plays a critical role in the home care intake process by ensuring that all incoming referrals are clinically appropriate and can be safely managed by the Home Health Agency. This role is responsible for thoroughly reviewing each referral to evaluate the patient’s care needs, confirm alignment with agency capabilities, and support safe, effective admissions.

In collaboration with referral sources, the Clinical Referral Processor ensures that all required clinical documentation and relevant patient information are complete and accurate. By proactively identifying gaps or clarifying care requirements, the processor facilitates timely scheduling of patient admissions and helps maintain high standards of clinical safety, regulatory compliance, and care coordination.

Responsibilities

Ensure safe and appropriate admissions by reviewing all referrals to confirm they align with the Home Health Agency’s clinical scope, capabilities, and safety standards.
Maintain regulatory compliance through accurate review and validation of ICD-10 diagnosis codes to ensure they meet home care regulatory and payer requirements.
Enable smooth care transitions by verifying all required clinical information is complete and actionable, including wound care orders, medication lists, and discharge summaries, prior to admission.
Support timely patient admissions by collaborating with data entry staff to ensure all referrals are accurately and promptly entered into the electronic medical record (EMR).
Reduce delays and rework by proactively identifying missing or incomplete referral information and facilitating resolution with referral sources.

Qualifications

Basic ICD-10 coding knowledge preferred to support accurate diagnosis review and regulatory compliance for home care services.
Strong computer and data entry skills with the ability to efficiently navigate electronic medical record (EMR) systems and related technology.
Excellent communication and relationship‑building skills to collaborate effectively with referral sources and ensure a smooth, timely transition of care.
Scheduling flexibility to participate in a shared intake rotation that includes coverage for one weekend day on a rotating basis.

Credentials