RN( Registered Nurse)Coor Quality Assurance HH( Home Health)- Fulltime Days

Wellstar Health System; LaGrange (GA); On-site; USD 85,000 - 110,000; Full time

Job summary

Wellstar Health System seeks an experienced RN for a Fulltime Day Shift in Home Health QA. The role includes reviewing OASIS, ensuring accurate coding, and auditing claims. Requires RN licensure and at least 3 years in Home Health, with OASIS and ICD10 recommended.

Responsibilities focus on documentation quality, compliance with Medicare guidelines, and collaboration with clinicians and billing teams to maintain high standards of care.

Qualifications

• RN licensed and actively practicing in Georgia or multi-state compact as applicable.
• OASIS and ICD-10 certification recommended and understood.
• Experience in home health QA or regulatory compliance preferred.

Responsibilities

• Accurately assigns diagnoses and codes based on documentation.
• Ensure 485s and related forms are complete and timely.
• Review OASIS for completeness and accuracy; support audits and actions.
• Audit final claims prior to billing release; support with action plans.

Skills

RN

OASIS

ICD10

Billing audits

QA

Education

Associate degree in Nursing

Diploma in Nursing

BSN preferred

Tools

EHR

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Job Summary

Fulltime Day Shift 40 hrs /week

RN required with 3 years Home Health for advanced/mainly non clinical role

3 YRs Home Health exp required - referably as an RN in QA

OASIS Certification and ICD10 Certification recommended.
Required

Core Responsibilities and Essential Functions

• Accurately and completely assigns appropriate diagnosis and codes
• Reviews and ensures 485s are correct and completed timely
• Reviews OASIS for completion, congruency and accuracy
• Generates HRRG score for RAPS
• Audits and reviews final claims for release to billing
• Works with Accreditation Coordinator on special projects, ensures accurate audits and assists with development of action plans as needed

Staff Review and Education

• Reviews documentation with Clinicians 485s, daily notes, OASIS timepoints
• Educates Clinicians on the appropriate way to complete OASIS timepoints
• Participates in orientation of new Clinical employees on OASIS documentation
• Assists in orientation of Clinical staff on Medicare Guidelines
• Attends team meetings to present documentation findings
• Assists on committees for education i.e. wound care, etc
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Regulatory

• Maintains current knowledge of federal, state, and regulatory guidelines related to billing, documentation, and coding
• Maintains knowledge of Medicare regulation and Conditions of Participation
• Transmits OASIS data to the State
• Maintains certification in OASIS and appropriate Coding ie.ICD9 and ICD 10

Customer Service

• Maintains a positive working relationship with all Wellstar Homecare departments and Clinical staff
• Serves as resource to Clinical staff and Managers

Required Minimum Education

• Associates Nursing or Diploma (Nurse) Nursing or Bachelors Nursing-Preferred

Required Minimum License(s) and Certification(s)

All certifications are required upon hire unless otherwise stated.

• RN - Reg Nurse (Single State) or RN-COMPACT - RN - Multi-state Compact

Additional License(s) and Certification(s)

OASIS Certification and ICD10 Certification recommended.
Required

Required Minimum Experience

Minimum 3 years Minimum of 3 years Home Health experience. Required and Previous Home Health QA experience Preferred

Required Minimum Skills

Professional, independent and self directed. Must possess excellent customer service skills and communication skills both written and verbal. Strong organizational skills with the ability to multi-task in a fast paced environment. Must have excellent computer proficiency

Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.