Oasis Specialist/ICD-10 Coder (57727)
About The Position
Responsible for the organization, development, monitoring, and management of the Quality Assessment and Performance Improvement (QAPI) program for Interim Healthcare. This role is responsible for coordinating the QAPI program for home care and hospice operations. The position involves completing all proper ICD-10 coding, reviewing all OASIS assessments, and managing the submission of OASIS and HIS/HOPE assessments to ensure timely submission within 30 days. The specialist will foster a professional environment that supports employee development and achievement of organizational goals through training and educational resources, utilizing QAPI Plus for data trending and QAPI initiatives. Collaboration with the VP of Quality is key for audit management, infection control, medication management, incident reporting, performance improvement project analysis, and survey readiness. Training for new and existing employees on OASIS, participation in Clinical Management team meetings, and serving as a resource for current requirements and guidelines are also essential functions. The role includes coordinating with leadership to ensure timely completion of Additional Documentation Requests (ADRs) and assisting the Pre Claim Review (PCR) team with issues related to non-affirmation. Ongoing professional development and completing additional assignments are expected, along with accessing personal health information (PHI) as necessary. Collaboration with agency leadership for monthly and quarterly audits is also a responsibility.
Requirements
- Nurse experience with active license in the state(s) in which they are employed and practices
- Strong attention to detail
- Experience working within a highly regulated industry
- One (1) year QA experience within the last five (5) years
- Certification as an OASIS Specialist-Clinical (COS-C) and Home Care Clinical Specialist – OASIS (HCS-O) required
- Working knowledge of CMS Condition of Participation in Home Health Services is required
- Able to effectively communication with clinical, non-clinical staff, providers, and or outside organizations
- Able to demonstrate skill in quality assurance review process
- Able to demonstrate skills in consultation, collaboration and systems management
- Working knowledge of federal and state home health licensure regulations is required
- Knowledge of medical terminology, anatomy and physiology, compliance, and reimbursement guidelines are required
- Sound computer skill and adaptability to home health documentation software is a must
Nice To Haves
- Case Management experience as defined by the contracting employer preferred
Responsibilities
- Complete all proper ICD-10 coding and review all OASIS assessments
- Lock down all SOC, Recerts, follow-up, discharges, and ROC OASIS and POCs
- Manage the submission of OASIS and HIS/HOPE assessments for all agencies, ensuring timely submission within 30 days
- Foster a professional environment that supports employee development and achievement of organizational goals through training and educational resources
- Utilize QAPI Plus (Centralized/Electronic QAPI Program) for data trending for the development of patient and employee education programs and QAPI initiatives, in partnership with the clinical management team
- Leverage the QAPI Plus application with VP of Quality to support audit management, infection control, medication management, incident reporting, performance improvement project (PIP) analysis, and survey readiness
- Collaborate with the VP of Quality to provide training for new and existing employees on OASIS, utilizing virtual platforms as needed
- Participate in Clinical Management team meetings as required
- Serve as a resource for current information on national, state, and regional requirements, standards, and clinical practice guidelines
- Coordinate with the VP of Quality, CSR Manager, and agency CSRs to ensure the timely completion of Additional Documentation Requests (ADRs)
- Collaborate with Pre Claim Review (PCR) team to assist as needed in resolving issues related to non-affirmation during the PCR process
- Demonstrate ongoing professional development
- Complete additional assignments as requested
- Access personal health information (PHI) as necessary to perform job duties, in accordance with organizational and departmental guidelines
- Collaborate with agency leadership (Director, ADON, and Clinical Supervisor) to help conduct monthly and quarterly audits in accordance with the agency’s QAPI plan and schedule
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
