Coding Quality Review Specialist II

SCR St. Claire Medical Center, Inc.; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

UK St. Claire is seeking a healthcare data coder to ensure accuracy and integrity of OASIS documentation and ICD-10 coding. You will collaborate with clinicians to resolve data gaps and ensure regulatory compliance for home health services.

The role requires 2–3 years in medical coding, with strong knowledge of OASIS processes and CMS standards. On-site work in Kentucky, with opportunities for ongoing education and competency development.

Qualifications

• Bachelor's degree in health information management, healthcare administration, or related field.
• Master's degree in health information management, healthcare administration, or related field preferred.
• 2–3 years of experience in medical coding, quality review, or related area.
• Equivalent combination of education and experience considered; paid experience only.

Responsibilities

• Assigns ICD-10 CM codes to diagnoses from OASIS, record documentation and care plans.
• Initiates and follows up with clients to obtain missing or incomplete information for accurate coding.
• Reviews OASIS documentation and ICD-10 coding to ensure accuracy and completeness.
• Consults with clinicians to clarify documentation discrepancies and recommends corrections per policy.
• Ensures clinical documentation meets CMS, Joint Commission, federal, and state regulations.
• Collaborates with Audit Specialist to clear charts for prompt and accurate billing.
• Maintains professional and technical knowledge in OASIS and ICD-10 Home Health Coding.
• Provides coding and OASIS education to clinicians onsite and virtually.
• Assists in developing and maintaining competency evaluations for employees on OASIS.
• Performs other duties as assigned.

Skills

ICD-10 coding

OASIS data integrity

CMS approvals

Communication with clinicians

Education

Bachelor's degree in health information management or related field

Master's degree preferred

Tools

EMR systems

coding software

Job description

At UK St. Claire, our staff is our greatest asset in the mission to create a healthier and more prosperous population. We strive to foster the talent and potential of our employees and prioritize safe working conditions and equal compensation rates to ensure that continual growth is possible. UKSC is a nurturing workplace for all healthcare professionals. We invite you to explore our current job openings and see if our opportunities could be the right fit for you.

Job Summary

Responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes. Ensures appropriate ICD-10 coding and sequencing for accurate reporting. Collaborates with clinical employees to clarify documentation and resolve data integrity issues. Supports quality improvement and compliance with regulatory standards.

Essential Functions

• Assigns ICD-10 CM codes to diagnoses from OASIS, record documentation, and care plans.
• Initiates and follows up with clients to obtain missing or incomplete information for accurate coding.
• Reviews OASIS documentation and ICD-10 coding to ensure accuracy and completeness.
• Consults with clinicians to clarify documentation discrepancies and recommends corrections per agency policy.
• Ensures clinical documentation meets CMS, Joint Commission, federal, and state regulations.
• Collaborates with Audit Specialist to clear charts for prompt and accurate billing.
• Maintains professional and technical knowledge in OASIS and ICD-10 Home Health Coding.
• Provides coding and OASIS education to clinicians onsite and virtually.
• Assists in developing and maintaining competency evaluations for employees on OASIS.
• Performs other duties as assigned.

Education Requirement

• Bachelor’s degree in health information management, healthcare administration, or a related field
• Master’s degree in health information management, healthcare administration, or a related field is preferred

Experience Requirement

• 2-3 years of experience in medical coding, quality review, or a relevant area
• An equivalent combination of education and experience may be considered. All experience must be paid and in the same related field. Part-time and PRN experience will be prorated based on hours worked per week. Volunteer work and internships for academic credit are not counted.

Certifications & Licensures

N/A

Working Conditions

• A. Lifting, pushing, and/or pulling objects up to 50lbs: 2. Occasional (< 10% of the time)
• B. Lifting, pushing, and/or pulling objects over 50lbs: 1. Never
• C. Standing or walking with objects up to 10lbs: 3. Intermittent (10% - 50% of the time)
• D. Standing or walking with objects up to 25lbs: 2. Occasional (< 10% of the time)
• E. Sitting at computer workstation for extended periods: 4. Regular (> 50% of the time)
• F. Risk of back injury from moving, lifting or positioning patients, equipment, or materials: 1. Never
• G. Repetitive motion: 4. Regular (> 50% of the time)
• H. Working at heights above 4 feet: 1. Never
• I. Working in confined spaces: 1. Never
• J. Risk of injuries from use of equipment on the job: 1. Never
• K. Job-related travel: 2. Occasional (< 10% of the time)
• L. Loud noises: 1. Never
• M. Temperature extremes: 1. Never
• N. Hazardous chemicals and fumes including waste: 1. Never
• O. Radiation: 1. Never
• P. Burns: 1. Never
• Q. Cuts/Punctures: 1. Never
• R. Bloodborne/airborne pathogens: 1. Never
• S. Recombinant DNA or viral vectors: 1. Never
• T. Combative/violent people: 1. Never
• U. Animal handling (including carcasses): 1. Never
• V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A

Physical Demands

This position requires regular sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; and occasional lifting, pushing, and/or pulling of objects up to 50 pounds or standing or walking with objects up to 25 pounds.

Additional Job Descriptions

N/A

Department

Home Health Shift: Day (United States of America) Time Type: Full time Address: 135 N. Hargis Ave. City, State: Morehead, Kentucky

Our growth is creating opportunities! Our team is expanding, and we want to hire the most talented people we can. Continued success depends on it!

Our Work Experience is the combination of everything that’s unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it’s our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful.