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Review clinical documentation and assign diagnostic codes based on current guidelines.
Consult with physicians and referral sources to clarify diagnoses.
Ensure clinical documentation quality and accuracy support reported diagnoses.
Maintain current PPS OASIS assessment and home health coding knowledge.
Provide educational guidance to staff on coding principles and guidelines.
Identify educational needs, prepare training materials, and assist with staff orientation and training to improve OASIS and coding skills. Travel to agency branch sites may be required.
Communicate regularly and effectively with managers and other disciplines.
Assess staff documentation skills and communicate evaluations to managers.
Perform documentation review, problem identification, and follow-up for billing regulatory compliance.
Educate team members on payer rules and regulations.
Examine, analyze, and interpret reports.
Work with support staff to facilitate pre-billing corrections.
Participate in special agency projects and programs.
Participate in quarterly chart audits and utilization review.
Serve on agency committees and task forces.
Perform various coding reviews and audits, 485 proofing, chart auditing for Medicare billing, and other Quality Improvement activities.
Perform other duties as assigned.

Current New York State license to practice as a Registered Nurse.
Working knowledge of current Medicare and Medicaid guidelines, OASIS, Coding, OBQI/OBQM, and government payment methodologies.
Two years experience in a Certified Home Care Agency.
Current certification in homecare coding (HCS-D) and OASIS (COS-C) – preferred

RN OASIS Reviewer at Valence Care - HCS - Girling NY - Extended Home Care - A&J Staffing - A Better Life - Direct Care

RN OASIS Reviewer