Job Description

The RN OASIS Reviewer is responsible for reviewing and coding clinical documentation.
QUALIFICATIONS:
· 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
· Excellent verbal and written communication skills
· Basic computer data entry and word processing skills
· Proven ability to work in a fast paced environment and meet deadlines
RESPONSIBILITIES:
1. Reviews all available clinical documentation, consults with field clinicians and/or clinical supervisors, and assigns appropriate diagnostic codes based upon current coding guidelines and conventions for all events requiring accurate coding and sequencing.
2. Consults with physicians and referral sources to clarify and update all diagnostic conditions and diagnoses as needed.
3. Reviews clinical documentation to ensure that quality and accuracy of documentation supports reported diagnoses.
4. Maintains current PPS OASIS assessment and home health coding knowledge base.
5. Provides educational guidance to staff in identifying and resolving issues, errors, or codes that do not conform to approved coding principles/guidelines.
6. Identifies educational needs, prepares training materials, and assists with orientation and ongoing training for clinical staff to improve OASIS and coding skills. Travel may be required to other agency branch sites as assigned.
7. Communicates regularly and effectively with managers and other disciplines.
8. Assesses staff documentation skills for provision of care and communicates evaluation to managers.
9. Performs documentation review, problem identification, and follow-up to ensure compliance with billing regulatory requirements.
10. Educates team members regarding all payer rules and regulations.
11. Examines, analyzes and interprets reports as appropriate.
12. Works with support staff to facilitate corrections prior to billing.
13. Participates in special agency projects and programs as assigned.
14. Takes part in quarterly chart audits and utilization review.
15. Serves on agency committees and task forces as needed.
16. Additional responsibilities may include various coding reviews and audits, 485 proofing for errors, chart auditing as necessary for final Medicare billing, and other Quality Improvement activities.
17. Other duties as assigned.
Rate: $90,000- $95,000