WFH Clinical Support Specialist
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Job Overview
Our client is seeking a Provider Support Specialist (RN) to serve as a clinical resource for physicians and advanced practice providers delivering virtual Transitional Care Management (TCM) services. This role provides real-time clinical, operational, documentation, and workflow support to ensure high-quality patient care, regulatory compliance, provider success, and exceptional patient outcomes.
Schedule: Remote, Full time | Monday - Friday, 8:30 AM - 5:00 PM PST, with a 30-minute paid lunch and two 15-minute unpaid breaks (40 work hours per week)
Responsibilities
- Provide daily clinical and operational support to telehealth providers.
- Support providers during virtual patient visits and resolve workflow issues.
- Review charts for documentation completeness, medical necessity, and compliance.
- Assist with educating providers on TCM, E/M coding, ICD-10-CM, CPT, and telehealth modifiers (93/95).
- Support responses to ADR, TPE, UPIC, CERT, and other audit requests.
- Monitor provider quality metrics and documentation timeliness.
- Coordinate with Coding, Quality, Credentialing, Care Management, and Operations.
- Identify trends and recommend process improvements.
- Assist with connecting patients to external resources.
Requirements
- Current unrestricted CA Registered Nurse (RN) license.
- Minimum three years of clinical nursing experience.
- Experience supporting physicians or advanced practice providers.
- Knowledge of telehealth workflows and electronic health records.
- Working knowledge of HIPAA, CMS, Medicare, and clinical documentation standards.
- Excellent communication, organization, and customer service skills.
Qualifications
- Experience in Transitional Care Management (TCM) and operations.
- Knowledge of Medicare billing and compliance.
- Clinical auditing or quality improvement experience.
Independent Contractor Perks
- Permanent work from home
- Immediate hiring
- Health Insurance Coverage for eligible locations
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