Quality Review and Coding Specialist, Continuum of Care
SSM Health
It's more than a career, it's a calling WI-SSM Health Monroe Home Health & Hospice Worker Type: Regular Job Highlights: Join a team where your work maters - every moment, every patient, every community. At SSM health, you'll be empowered to grow, supported to thrive and inspired to make a lasting impact. In this role, Home Health & Hospice Coding Specialists play a critical role in ensuring accurate clinical documentation, coding integrity, and regulatory compliance. Working collaboratively with clinicians and operational leaders, they help support quality patient care, reimbursement accuracy, and organizational success across our Home Health and Hospice programs. Department: Continuum of Care, Coding Schedule: This full-time, 40-hour coding position is remote with flexible hours. Job Summary Responsible for performing audits and coding patient charts at the appropriate timepoints in care. This role will review assessments and plans of care to ensure that the coded diagnoses on patient charts are accurately reflected in assessment and plan of care documentation. Job Responsibilities and Requirements
PRIMARY RESPONSIBILITIES
- Utilizes computerized coding/abstracting equipment, codes all diagnoses/procedures in accordance with coding guidelines while meeting quality and productivity standards.
- Provides necessary assistance to field staff and leadership to Outcome and Assessment Information Set (OASIS), Healthy Outcomes from Positive Experiences (HOPE), and/or ICD-10 queries.
- Assists coders and quality review staff in performance of duties.
- Maintains and reports statistical information when applicable.
- Reviews daily reports to ensure all records are processed.
- Consults with field clinical staff regarding appropriate ICD codes and sequencing.
- Performs other duties as assigned.
EDUCATION
- High School diploma/GED or 10 years of work experienceEXPERIENCE
- Two years' experiencePHYSICAL REQUIREMENTS
- Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
- Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
- Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
- Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
- Frequent keyboard use/data entry.
- Occasional bending, stooping, kneeling, squatting, twisting and gripping.
- Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
- Rare climbing.
REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS
State of Work Location: Illinois Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board Or Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board Or Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Registered Nurse (RN) - Missouri Division of Professional Registration Or Registered Nurse (RN) Issued by Compact State State of Work Location: Oklahoma Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board Or Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) State of Work Location: Wisconsin Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board Or Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance Or Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance Or Registered Nurse (RN) Issued by Compact State Or Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: View phone number on click.appcast.io Hospice-HH Coding Scheduled Weekly Hours: 40 SSM Health is an Equal Opportunity Employer. SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. #J-18808-Ljbffr SSM Health- ...Cohere Health seeks an experienced RN Reviewer to perform prospective, concurrent, and retrospective reviews ensuring medical necessity and high-quality care. You will collaborate with Medical Directors, providers, and cross-functional teams to apply MCG and Cohere guidelines...QualityRemote workFlexible hours
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