Registered Nurse – Clinical Support & Billing/Coding

Full-Time | Monday–Friday | 9:00 AM–5:00 PM Pacific Time | Possible Weekends

Position Summary: Nurse Next Door is seeking an experienced and knowledgeable Registered Nurse (RN) to provide clinical and nursing support to our caregivers, clients, and administrative team.

The primary focus of this position is nursing and clinical support. The RN must be comfortable assessing situations over the phone, answering clinical questions, guiding caregivers and clients through appropriate next steps, and serving as a knowledgeable clinical resource for the organization.

The ideal candidate will have broad clinical knowledge, including a strong understanding of current treatments, therapies, medications, and healthcare resources available in the United States, and the ability to clearly communicate clinical information to caregivers and clients.

This position will also have responsibilities related to clinical documentation, billing, coding, OASIS, and regulatory compliance. Billing and coding experience is important; however, it is not the primary focus of the position.


Essential Duties & Responsibilities:

-Provide clinical and nursing support to caregivers, clients, and agency staff.
-Respond to clinical questions and concerns by phone and provide appropriate nursing guidance within the RN scope of practice and agency protocols.
-Walk caregivers and clients through clinical situations, helping them understand appropriate next steps and when escalation to a physician, emergency services, or another healthcare provider is necessary.
-Serve as a clinical resource for caregivers providing care in clients’ homes.
-Maintain current knowledge of commonly used treatments, therapies, medications, medical equipment, and healthcare services available in the United States.
-Assist with care coordination and communication between caregivers, clients, families, providers, and the clinical team.
-Review clinical documentation for completeness, accuracy, and compliance.
-Review and validate OASIS assessments as applicable.
-Assist with ICD-10 diagnosis coding and ensure appropriate coding practices.
-Support home health billing processes and documentation requirements.
-Identify documentation deficiencies and work with clinicians to obtain necessary corrections.
-Assist with claim issues, denials, documentation requests, and billing-related clinical questions.
-Maintain strict confidentiality and HIPAA compliance.
-Provide additional nursing, clinical, and administrative support as needed.

Required Qualifications:
-Active and unrestricted Registered Nurse (RN) license.
-Clinical nursing experience with the ability to independently assess and respond to clinical situations.
-Strong knowledge of treatments, therapies, medications, and healthcare services commonly available in the United States.
-Ability to confidently provide nursing guidance and support to caregivers and clients over the phone.
-Knowledge or experience with medical billing and coding.
-Understanding of ICD-10 coding principles.
-Familiarity with clinical documentation and regulatory compliance.
-Strong critical-thinking and problem-solving skills.
-Excellent verbal and written communication skills.
-Strong organizational skills and attention to detail.
-Comfortable working independently and making appropriate clinical decisions within the RN scope of practice.
-Proficiency with electronic medical records and standard computer systems.
-HIPAA Training.

Preferred Qualifications:
-Experience in home care, home health, hospice, case management, or telephone/triage nursing.
-Experience with OASIS documentation and review.
-Degree, certification, or formal training in Medical Billing & Coding.
-Certified OASIS Specialist (COS-C) or equivalent certification.
-Home health coding certification (HCS-D or similar).
-Experience with Medicare home health reimbursement and PDGM.
-Quality Assurance or Clinical Documentation Review experience.

Knowledge & Skills:
-Successful candidates should have knowledge or experience in several of the following areas:
-Clinical nursing and patient assessment
-Telephone nursing support and clinical triage
-Caregiver education and support
-Client and family education
-U.S. treatment and therapy options
-Medication and treatment knowledge
-Home care and home health services
-Clinical documentation
-ICD-10-CM coding
-Medicare and Medicaid requirements
-Medical billing and claims
-Regulatory compliance
-HIPAA
-Quality assurance
-Clinical documentation improvement

Schedule: This is a full-time position working Monday through Friday, 9:00 AM–5:00 PM Pacific Time (United States).

Candidates must be consistently available during these hours. Occasional weekend availability may be required based on clinical and operational needs.

***Please briefly describe your RN experience providing clinical guidance to caregivers or patients, including your experience with U.S.-based treatments/therapies, clinical documentation, and medical billing/coding.***