Nurse PDPM & Documentation Auditor

ACS pro Global Corporation; Bulacan; On-site; PHP 469,000 - 781,000; Full time

Job summary

ACS pro Global Corporation in the Philippines is seeking a Nurse Reviewer to organize and audit rehabilitation and clinical documentation, including MDS, and review codes for accurate PDPM scoring. The role involves examining supporting documents and preparing records for submission to insurance companies for reimbursement.

The candidate will obtain therapy records from NetHealth, perform audits, create checklists, ensure dates and signatures are accurate, and upload documents to SharePoint for

Qualifications

• BSN graduate with a nursing license.
• Excellent verbal and written communication for collaboration with healthcare professionals.
• Understanding of PDPM framework and its impact on documentation and reimbursement.
• Proficient with EHRs and healthcare software.
• Strong medical terminology for accurate documentation.
• Attention to detail ensuring data accuracy and compliance.
• Able to multitask in a fast-paced environment.
• Compliant with HIPAA and confidentiality protocols.

Responsibilities

• Obtain therapy records from the EMR (NetHealth) for rehab records.
• Review claims and diagnosis codes with supporting documents.
• Create checklists to verify document details before review.
• Perform Med B TPE audits and organize NH records and attestations.
• Identify rehab audits requiring orders or summaries and train on process.
• Upload all documents to SharePoint for timely submission to insurers.

Skills

BSN

Strong Communication Skills

PDPM Knowledge

Tech-Savvy

Medical Terminology

Detail-Oriented

Multitasking

HIPAA Compliance

Education

Bachelor of Science in Nursing (BSN)

Job description

ACS pro Global Corporation in the Philippines is seeking a Nurse Reviewer to organize and audit rehabilitation and clinical documentation, including MDS, and review codes for accurate PDPM scoring. The role involves examining supporting documents and preparing records for submission to insurance companies for reimbursement.

The candidate will obtain therapy records from NetHealth, perform audits, create checklists, ensure dates and signatures are accurate, and upload documents to SharePoint for