Quality Review ADR LVN

Job Summary

The ADR LVN plays an important role in supporting the agency’s quality and compliance efforts through clinical review, assembly, and preparation of records in response to Additional Documentation Requests (ADRs) from payor sources as well as Medical Records Requests from other sources. This position helps ensure documentation is accurate, complete, and supportive of billed home health services while promoting audit readiness and strong clinical documentation practices. This role will also cross-train in QA review, including OASIS review, offering the opportunity to expand skills in documentation quality, regulatory compliance, and clinical excellence.

Responsibilities and Duties

• Review clinical records for ADRs and other medical records requests to ensure documentation is complete, accurate, and supports services billed.
• Organize, assemble, and prepare records for timely submission and completion in accordance with internal policies, payer, and regulatory requirements.
• Partner with branch leaders, clinicians, and support teams to ensure accurate and complete documentation.
• Monitor ADR deadlines and maintain an organized workflow to support timely and accurate submissions.
• Identify documentation concerns, trends, and compliance risks, and communicate findings to appropriate leaders in order to ensure future requests are compliant and correct.
• Support agency audit readiness by helping strengthen documentation quality and consistency.
• Crosstrain in OASIS QA review and assist with review of OASIS assessments for accuracy, consistency, and compliance with applicable guidance and agency standards as needed.
• Provide constructive feedback and support to clinicians and leaders related to documentation opportunities and compliance expectations.
• Maintain confidentiality of protected health information (PHI) and perform all duties in accordance with agency policy and regulatory requirements.
• Contribute to the overall success of the Quality and Compliance team through collaboration and other related duties as assigned.
  
  

Qualifications and Skills

• Current LVN/LPN license in good standing in the state of practice required.
• Home health clinical experience required.
• Knowledge of Medicare home health documentation requirements, medical necessity standards, and regulatory expectations preferred.
• Strong attention to detail, critical thinking, and organizational skills.
• Ability to manage multiple priorities and meet deadlines in a fastpaced environment.
• Effective written and verbal communication skills with the ability to work collaboratively across teams.
• Proficiency with electronic medical records and standard business software applications.
  
  

Preferred Qualifications

• Experience with ADR preparation, audit response, clinical review, or documentation review preferred.
• Familiarity with OASIS guidance and quality assurance processes preferred, or willingness to successfully crosstrain in OASIS QA review.
  
  

Why Join This Role

This position is a great opportunity for an LVN who enjoys clinical review, documentation quality, and compliance work, and who is looking to grow their knowledge in both ADR management and OASIS QA.

Salary: TBD

Benefits:

• Health, Vision, Dental, Supplemental Insurance
• Employee Assistance Program
• Flexible Spending Account
• Life Insurance
• Paid Time Off
• Extended Illness Bank
• 401(k) up to 3.5 Match
• Wellness Incentive Program
• Physical Activity Policy
• Employee Referral Bonus
• Volunteer Service
• Continuing Education & Tuition Assistance