As a Per Diem Chart Reviewer at Daymark, you will be a key member of the Enrollment and Care Teams, supporting accurate program eligibility determinations for patients. You will review medical records, apply established clinical criteria, and ensure documentation supports eligibility for Daymark programs. Your role is essential in maintaining the integrity of our care delivery and supporting patients.

WHAT YOU'LL DO

In this role, you will conduct thorough reviews of medical records to support program eligibility determinations. On a day-to-day basis, this may include:

• Chart Review: Conduct retrospective and concurrent reviews of inpatient, outpatient, and ancillary medical records to assess whether clinical documentation supports eligibility for Daymark Health's programs.
• Criteria Application: Apply established clinical criteria and program-specific guidelines to evaluate medical necessity and eligibility determinations.
• Clinical Documentation: Accurately abstract and document relevant clinical findings, diagnoses, procedures, and treatment history from the medical record.
• Escalation & Collaboration: Identify documentation gaps or inconsistencies and escalate cases requiring physician or supervisor review as appropriate.
• Compliance: Maintain strict confidentiality of all patient health information in accordance with HIPAA regulations and Daymark's policies, procedures, and documentation standards.
• Quality Assurance: Participate in audits, quality reviews, and process improvement initiatives as requested, and stay current on program eligibility criteria and relevant regulatory updates.

What We Are Looking For

• Experience: An active, unrestricted Registered Nurse (RN) license in good standing is required. A minimum of 5 years of Oncology nursing experience required, with experience in case management strongly preferred.
• Clinical Knowledge: Working knowledge of medical terminology, and clinical documentation standards.
• Comfort with Technology: Proficiency with electronic health record (EHR) systems and comfort with tools such as Google Suite, Zoom, and Slack.
• Analytical Skills: Strong critical thinking and attention to detail, with the ability to review and interpret complex clinical documentation independently.
• Patient-Centric Approach: A deep commitment to Daymark's mission to support cancer patients with dignity & compassion.
• Organizational Skills: Ability to manage multiple reviews simultaneously, meet established turnaround times, and maintain meticulous documentation.
• Adaptability: Comfortable working independently in a dynamic environment with minimal supervision

Additional Information

This is a per diem, remote role. Availability of a minimum of 10 hours per week is required. Hours and schedule will vary based on organizational need, but typically range 10-20 hours per week. 2-3 hours of availability daily is strongly preferred over fewer, longer time periods. 

Compensation will range from $40 to $55 per hour, depending on a candidate's location and experience. Per diem employees are not eligible for benefits.