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Clinical Coding and OASIS Reviewer

Role overview

Qualifications

  • Active Compact RN Nursing License
  • Minimum of 2 years clinical experience
  • COS-C or HCS-O or COQS OASIS Certification and experience
  • Competency in PC skills

Responsibilities

  • Compare the CMS-485 against referral documents for consistency and medical necessity
  • Review and communicate OASIS edit recommendations to clinicians
  • Provide customer service and education regarding CMS guidelines
  • Perform related duties as required by Manager/Director

Key facts

Hard skills

Other skills

  • Communication
  • Customer Service
  • Problem Solving

About the company

BAYADA Home Health Care logo

BAYADA Home Health Care

Home Health Care

BAYADA Home Health Care was founded by J. Mark Baiada in 1975 and provides nursing, rehabilitative, therapeutic, hospice, and assistive care services to children, adults, and seniors in the comfort of their homes. Headquartered in the Greater Philadelphia suburbs of New Jersey, BAYADA is a leading nonprofit home health care provider—with hundreds of locations in the US, as well as Germany, India, Ireland, New Zealand, and South Korea—and the only national provider that offers a full range of home-based specialty care services.

Company details

Company typeXLarge
IndustryHome Health Care
Company size10001

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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.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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