Packet Review / Coding Specialist

Job Description Summary The OASIS Review and Coding Specialist is a professional responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes. This position ensures appropriate ICD-9 – ICD-10 coding and sequencing and works with clinical staff to clarify documentation and data integrity issues. Must hold a valid nursing license. Responsibilities Prospectively reviews all OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy. Utilizes OASIS variation or alert reports when reviewing OASIS data. Ensures appropriate ICD-9 – ICD-10 coding and sequencing as it relates to the patient’s medical condition, including any co-morbidities. Consults with appropriate clinical staff to clarify any data integrity issues and works with the clinician to make appropriate corrections per organization policy. Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee. Notifies organization leadership of problematic trends as a result of OASIS review. Works with managers to address trends that affect the agency’s outcome and process measures noted during OASIS review. Participates in Quality Improvement and Corporate Compliance activities as assigned. Assists with other chart audit activities as assigned. Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications. Qualifications This position must hold a valid nursing license. Coding experienced – preferred. Proficient knowledge of OASIS and ICD-9/ICD-10 coding. OASIS certification (COS-C) preferred; OASIS Home Health ICD-9/ICD-10 coding certification preferred. Knowledge of federal regulations and state licensure requirements. Working knowledge of computer systems. Licensed driver with automobile that is in good working order and insured in accordance with organization requirements. Excellent coordination and communication skills. Detail oriented and able to work with minimal supervision. We are an equal opportunity employer committed to ensuring that all conditions and privileges of employment, including recruitment, hiring, evaluation, transfer, promotion, discipline, determination of compensation and/or benefits, and termination of employment, for all job classifications, are based on qualifications and work record. No employment decision is made, nor do we discriminate, on the basis of race, color, religion, creed, sex/pregnancy, sexual orientation, gender identity, gender expression, age, national origin, ancestry, citizenship, veteran status, or disability. #J-18808-Ljbffr Deercreekseniorliving