Clinical Coding Specialist

3 weeks ago


Reston, Virginia, United States Good Samaritan Hospital Full time
Job Title: Home Care Quality Assurance and Coding Review Clinician

The Home Care Quality Assurance and Coding Review Clinician plays a vital role in ensuring excellent clinical outcomes and accurate HHRG Coding at Good Samaritan Hospital. This position assists the PI Manager in reviewing OASIS assessments and 485 for completeness and accuracy with coding based on ICD and CPT classification systems.

Responsibilities:
  • Reviews all admissions, discharges, and recertifications where appropriate.
  • Correctly codes diagnoses and procedures on all admissions using ICD-9(10) coding.
  • Compares chart documentation with Oasis documentation and ensures that coding and OASIS documentation follows all federal & state regulations.
  • Works with the Team Managers and PI Manager in conducting chart audits flagged for coding and OASIS accuracy issues.
  • Performs quality improvement measures and utilization review of medical records under the supervision of the PI Manager.
  • Audits medical records and provides reports based on coding and documents results as needed.
  • Completes comprehensive order review and advises if corrections are needed to field staff.
Qualifications/Requirements:

Experience: Minimum of 5 years field experience. Proficient with Coding, OASIS, and Home Health Prospective Payment System (PPS).

Education: Bachelor's degree from an accredited School of Nursing, Physical Therapy, or Occupational Therapy.

Licenses/Certifications: Currently licensed as a Registered Nurse, Physical Therapist, or Occupational Therapist in the state of New York.



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