Utilization Review Specialist, RN

🕒 2 days ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $65k - $85k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Concierge Home Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2015

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Concierge Home Care is a Florida-based home healthcare agency that provides personalized in-home care services for seniors, helping them manage chronic conditions and remain safely in their homes. The company operates in hundreds of cities across Florida, employs carefully screened and insured caregivers, uses multidisciplinary care plans, coordinates with discharge planners and healthcare professionals, and assists with Medicare and insurance coverage. It also offers career opportunities, a franchise/network option for other home health agency owners, and emphasizes HIPAA-compliant practices and community-focused care.

📋 Description

• Review home health clinical documentation for accuracy and compliance • Audit OASIS documentation and care plans • Ensure coding accuracy and reimbursement integrity • Collaborate with Branch Directors, Clinical Managers, and field clinicians • Support quality assurance and regulatory compliance initiatives • Maintain productivity while reviewing high-volume documentation • Join Concierge Home Care’s remote home health team • Work a weekday Monday–Friday schedule with occasional weekend rotation of one weekend per month

🎯 Requirements

• Active Florida RN License (unencumbered) • OASIS Certification • Home Health Coding Certification • Minimum 2 years of Home Health experience • Strong knowledge of Medicare guidelines and home health regulations • Ability to work independently in a remote setting • Excellent attention to detail and organizational skills • Employment contingent upon successful completion of an AHCA Level 2 background screening • WellSky/Kinnser experience preferred • SHP platform experience preferred • Prior QA, Utilization Review, or Clinical Auditing experience preferred

🏖️ Benefits

• Quarterly Bonuses & Incentives • Full Benefits Package • Medical, Dental & Vision Insurance • Life Insurance • 401(k) • 3 Weeks PTO • Quarterly Bonus Opportunities • Employee Referral Program • Free CEUs • Data Plan Reimbursement • Career Growth Opportunities • Monday–Friday or Weekend Schedule Options • Remote work flexibility