Clinical Coding and OASIS Reviewer

Remote role but must be willing to work 8:30-5 Eastern time.

Please note- Candidates must have COS-C HCS-O or COQS and HCS-D or BCHH-C certifications in order to be considered.

BAYADA Home Health Care has an immediate opening for aFull TimeQuality Reviewer with OASIS certification to work remotely. RNs with certifications will be considered for this role.

The Quality Reviewer is responsible for auditing validating and optimizing the patients Plan of Care (Form CMS-485) and OASIS assessments. This role ensures clinical accuracy regulatory compliance with Medicare/CMS guidelines and appropriate reimbursement for home health services.

BAYADA Perks:

• This is a fully remote position.
• Base Salary:$77000 - $80000/ year
• BAYADA offers acomprehensive benefits planthat includes the following: Paid holidays vacation and sick leave vision dental and medical health plans employer paid life insurance 401k with company match direct deposit and employee assistance program.

Responsibilities:

• Compare the CMS-485 against referral documents History & Physical (H&P) OASIS and therapy/nursing evaluations for 100% consistency and medical necessity.
• Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy.
• Timely review and coding of diagnoses and OASIS documents with productivity maintained at the quarterly target set by the Director of MCM.
• Review clinical information for appropriateness congruency and accuracy as it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines.
• Provide support and communication to all disciplines within the service.
• Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines PDGM guidelines and billing related issues.
• Provide ongoing communication with service offices via e-mail zoom or telephone (specific to the service office needs).
• Communication with service offices monthly and as appropriate with a focus on documentation trends star ratings and potential revenue impact.
• Perform related duties or as required or requested by Manager/Director.

Qualifications:

• Competency in PC skills required to perform job function.
• Active Compact RN Nursing License with a minimum of 2 years clinical experience.
• COS-C or HCS-O or COQS OASIS Certification and experience required.
• HSC-D or BCHH-C.
• HCHB experience a plus!

As an accredited regulated certified and licensed home health care provider BAYADA complies with all state/local mandates.

BAYADA is celebrating 50 years of compassion excellence and reliability. Learn more about our 50th anniversary celebration and how you can join in here.

BAYADA Home Health Care Inc. and its associated entities and joint venture partners are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex race color age disability pregnancy or maternity sexual orientation gender identity citizenship status military status or any other similarly protected status in accordance with federal state and local laws. Hence we strongly encourage applications from people with these identities or who are members of other marginalized communities.