Clinical Coding and OASIS Reviewer

BAYADA Home Health Care; United States; Remote; USD 77,000 - 80,000; Full time

Benefits offered by this job

Remote work

Competitive salary

Comprehensive benefits

Job summary

BAYADA Home Health Care is hiring a Full Time Quality Reviewer with OASIS certification to work remotely. RN’s with certifications will be considered for this role.

The Quality Reviewer audits, validates, and optimizes the patient’s Plan of Care and OASIS assessments, ensuring regulatory compliance and proper reimbursement for home health services.

Qualifications

• Must hold COS-C, HCS-O or COQS OASIS certification.
• Active Compact RN Nursing License with a minimum of 2 years clinical experience.
• HCHB experience is a plus.

Responsibilities

• Audit CMS-485 against referral documents, H&P, and therapy/nursing evaluations for consistency and medical necessity.
• Review and communicate OASIS edit recommendations to clinicians to promote accuracy.
• Provide support and communication to all disciplines within the service.
• Assist with CMS guidelines, PDGM guidelines and billing-related issues for service offices.
• Maintain ongoing communication with service offices via e-mail, Zoom, or telephone.
• Communicate with service offices monthly about documentation trends and potential revenue impact.
• Perform related duties as requested by Manager/Director.

Skills

PC skills

RN license

OASIS knowledge

COS-C/HCS-O/COQS

HCHB knowledge

Education

Active RN Nursing License

OASIS Certification (COS-C/HCS-O/COQS)

Tools

HCHB

Job description

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

Please note- Candidates must have COS-C, HCS-O or COQS in order to be considered, there is no flexibility around this requirement.

BAYADA Home Health Care has an immediate opening for a Full Time, Quality Reviewer with OASIS certification to work remotely. RN’s with certifications will be considered for this role.

The Quality Reviewer is responsible for auditing, validating, and optimizing the patient’s 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: $77,000 - $80,000 / year
• BAYADA offers a comprehensive benefits plan that 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.
• 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
• 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.