Review Specialist, OASIS & 485

OASIS Review Coding Specialist

This is a remote position that provides flexibility and control over assigned workload. The OASIS Review Coding Specialist is responsible for performing 485 Review, OASIS Review, and coding duties while providing excellent service levels deserved by all MatrixCare customers. This role reports to the Supervisor of Coding and Review Operations or Manager of Coding and Review Services.

Responsibilities:

• Coding level exceeds (or at minimum perform at required productivity levels equivalent of 8 completed 485 review or 10 completed OASIS Reviews per day for FT employees).
• Extract clinical information from OASIS Assessment as well as a variety of medical records.
• Assign appropriate ICD-10 Code(s) based on medical records according to established procedures and coding guidelines.
• Suggest changes to OASIS responses based on documentation in the medical record according to established Oasis guidance.
• Recommend changes to the 485 locators based on clinical documentation and in accordance with COP's.
• Works with external coding databases and industry accepted tools.
• Communicate with agencies effectively and provide excellent customer service.
• Work is completed and documented accurately and timely.
• Conducts peer audits as needed/assigned.
• Regularly provides feedback for processes and performance improvement.
• Quickly ascertain customer needs through research and communication and provide quality solutions.

Qualifications:

• Graduate of accredited school of professional nursing and BSN preferred.
• 2 years of home health OASIS/485 review and coding experience.
• 5 years' experience in home health and/or hospice preferred.
• A thorough education in EMR systems, coding regulations, PDGM and medical terminology with proven coding capabilities.
• Certification in home health coding (HCS-D or BCHH-C in ICD-10).
• Certification in OASIS (COS-C or HCS-O).
• Experience in quality assurance (QA) or case management a plus.
• Experienced in review of the 485 in line with industry and regulatory standards.
• Ability to communicate effectively with agency staff, management, and other members of the team.
• The ability to make clear, decisive clinical decisions.
• Must understand the impact of clinical decisions as it relates to agency operations and financial impact.
• Must have the ability to justify and at times, defend clinical decisions and documentation.
• Exceptional computer, software and typing skills.
• Must have the ability to work independently, with dynamic and changing priorities while meeting or exceeding targeted event quota.
• Skilled in dealing with a high volume of competing tasks in a fast-paced environment. Strong focus on problem-solving initiatives and quick resolution.
• Detail-oriented as proper billing and reimbursement depend on coding expertise.
• Must comprehend the basics of medicine, such as anatomy, physiology, diseases, and diagnoses. This knowledge is essential for coders, as they will be required to accurately translate medical jargon into code.
• Organized, efficient and precise with strong communication and liaison skills, dependable and hard working with extensive background in quality customer support.
• Must comprehend the basics of home health and hospice business operations, insurance claims processes, and basic office procedures.

We are shaping the future at ResMed, and we recognize the need to build on and broaden our existing skills and continue to attract and retain the world's best talent. We work hard to offer holistic benefits packages, provide flexible work arrangements, cultivate a workforce culture that allows employees to grow personally and professionally, and deliver competitive salaries to our team members. Employees scheduled to work 30 or more hours per week are eligible for benefits.

This position qualifies for the following benefits package: comprehensive medical, vision, dental, and life, AD&D, short-term and long-term disability insurance, sleep care management, Health Savings Account (HSA), Flexible Spending Account (FSA), commuter benefits, 401(k), Employee Stock Purchase Plan (ESPP), Employee Assistance Program (EAP), and tuition assistance.

Employees accrue fifteen days Paid Time Off (PTO) in their first year of employment, receive 11 paid holidays plus 3 floating days and are eligible for 14 weeks of primary caregiver or two weeks of secondary caregiver leave when welcoming new family members.

Individual pay decisions are based on a variety of factors, such as the candidate's geographic work location, relevant qualifications, work experience, and skills.

Base Pay Range for this position:

$62,000.00 - $80,000.00

For remote positions located outside of the US, pay will be determined based the candidate's geographic work location, relevant qualifications, work experience, and skills.