Quality Review and Coding Specialist, Continuum of Care

SSM Health; Monroe (WI); A distancia; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

SSM Health Monroe Home Health & Hospice is seeking a Home Health & Hospice Coding Specialist to ensure accurate clinical documentation, coding integrity, and regulatory compliance across our Home Health and Hospice programs. This full-time, 40-hour position is remote with flexible hours, serving as a vital link between clinicians, leadership, and reimbursement teams.

You will audit charts, code diagnoses and procedures per guidelines, and support field staff with OASIS, HOPE, and ICD-10 queries

Formación

• High School diploma or 10 years of work experience required.
• Experience in clinical coding and documentation.
• Knowledge of regulatory coding guidelines.

Responsabilidades

• Codes all diagnoses/procedures per guidelines with quality and productivity standards.
• Assists field staff with OASIS, HOPE, and ICD-10 queries.
• Supports coders and quality review staff in duties.
• Maintains and reports statistical information.
• Reviews daily reports to ensure records are processed.
• Consults with field clinical staff on ICD codes and sequencing.
• Performs other duties as assigned.

Conocimientos

Coding/abstracting

OASIS knowledge

Regulatory compliance

Team collaboration

Educación

High School diploma/GED or 10 years of work experience

Herramientas

Coding software

Descripción del empleo

It's more than a career, it's a calling

WI-SSM Health Monroe Home Health & Hospice

Worker Type

Regular

Job Highlights

Join a team where your work maters - every moment, every patient, every community. At SSM health, you'll be empowered to grow, supported to thrive and inspired to make a lasting impact.

In this role, Home Health & Hospice Coding Specialists play a critical role in ensuring accurate clinical documentation, coding integrity, and regulatory compliance. Working collaboratively with clinicians and operational leaders, they help support quality patient care, reimbursement accuracy, and organizational success across our Home Health and Hospice programs.

Department: Continuum of Care, Coding

Schedule: This full-time, 40-hour coding position is remote with flexible hours.

Job Summary

Responsible for performing audits and coding patient charts at the appropriate timepoints in care. This role will review assessments and plans of care to ensure that the coded diagnoses on patient charts are accurately reflected in assessment and plan of care documentation.

Job Responsibilities and Requirements

Primary Responsibilities

• Utilizes computerized coding/abstracting equipment, codes all diagnoses/procedures in accordance with coding guidelines while meeting quality and productivity standards.
• Provides necessary assistance to field staff and leadership to Outcome and Assessment Information Set (OASIS), Healthy Outcomes from Positive Experiences (HOPE), and/or ICD-10 queries.
• Assists coders and quality review staff in performance of duties.
• Maintains and reports statistical information when applicable.
• Reviews daily reports to ensure all records are processed.
• Consults with field clinical staff regarding appropriate ICD codes and sequencing.
• Performs other duties as assigned.

EDUCATION

• High School diploma/GED or 10 years of work experience

Experience

• Two years' experience

Physical Requirements

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

Required Professional License And/Or Certifications

State of Work Location: Illinois

• Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board
• Or
• Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR)

State of Work Location: Missouri

• Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board
• Or
• Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Registered Nurse (RN) - Missouri Division of Professional Registration
• Or
• Registered Nurse (RN) Issued by Compact State

State of Work Location: Oklahoma

• Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board
• Or
• Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Registered Nurse (RN) Issued by Compact State
• Or
• Registered Nurse (RN) - Oklahoma Board of Nursing (OBN)

State of Work Location: Wisconsin

• Certificate for OASIS Specialist-Clinical (COS-C) - OASIS Certificate & Competency Board - OASIS Certificate & Competency Board
• Or
• Home Care Clinical Specialist - OASIS (HCS-O) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist - Diagnosis (HCS-D) - Board of Medical Specialty Coding and Compliance
• Or
• Home Care Coding Specialist- Hospice (HCS-H) - Board of Medical Specialty Coding and Compliance - Board of Medical Specialty Coding and Compliance
• Or
• Registered Nurse (RN) Issued by Compact State
• Or
• Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services

Work Shift

Day Shift (United States of America)

Job Type

Employee

Department

8444000114 Hospice-HH Coding

Scheduled Weekly Hours

40

SSM Health is an Equal Opportunity Employer. SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law.