Clinical Reviewer

3 weeks ago


Westerville, Ohio, United States Ohio Living Full time
Clinical Reviewer Job Description

We are seeking a detail-oriented and organized Clinical Reviewer to join our team at Ohio Living. As a Clinical Reviewer, you will play a crucial role in ensuring the quality of patient care by reviewing and approving patient information, promoting stable relationships with referral sources, patients, caregivers, and staff members, and assisting with the training of agency staff.

Responsibilities:

Process Home Health Starts of Care (SOC) or Hospice Admission Plans of Care timely, working with assigned Home Health and Hospice office.
Maintain accepted productivity of all Plans of Care.
Assist other Clinical Reviewers as needed to ensure Ohio Living Home Health and Hospice meets accepted benchmarks for Plan of Care completion and provider approval.
Complete review of evaluation packets, OASIS-C, 485s, and other clinical information for home health and hospice, ensuring consistency with the comprehensive assessment of the 485.
Review data submitted from field staff to ensure accuracy and follow up on any documentation that requires correction.
Complete ICD-10 coding based on clinical documentation in accordance with company standards and federal, state, and local standards, guidelines, and regulations.

Requirements:

High school diploma or equivalent required.
Current Ohio nursing license to practice as a Licensed Nurse (LPN) preferred or at least two years of post-secondary education in a clinical specialist or medical records program.
Certificate for OASIS Specialist-Clinical (COS-C) designation from the OASIS Certificate and Competency Board (OCCB) preferred.
Certification in ICD-10 diagnosis coding required or willing to obtain within six months of hire.
Two years of medical-surgical, medical records management, or healthcare billing experience required.
Experience with ICD-10 medical coding required.
Experience in a Medicare-certified home health agency preferred.

Why Work at Ohio Living?

Ohio Living is a faith-based, not-for-profit organization that provides caring and quality services to adults in 50 Ohio counties. We offer a comprehensive benefits package, including competitive wages, medical, dental, and vision insurance, 403b retirement savings, paid time off, training, continuing education, and education assistance. We are committed to providing an engaging, recognition-centered, team-oriented workplace dedicated to career, family, and faith.
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