RN, home Health Coding/Quality Improvement

3 days ago

Pittsburgh, Pennsylvania, United States Jewish Association on Aging Full time

JOB SUMMARY:

The Quality Assurance/Coding is responsible for the tracking and trending of all Quality initiatives in Home Health. The Home Health Coder is responsible for reviewing clinical documentation and assigning appropriate ICD-10, codes to ensure accurate billing for home health services. This role requires a strong understanding of home health care regulations, coding guidelines, and the ability to work collaboratively with clinical and billing staff to ensure compliance with CMS regulations.

JOB DUTIES / RESPONSIBILITIES

  1. Performs coding and assures it is compliant with CMS guidelines, OASIS assessments, and home health-specific regulations.

2. Demonstrate knowledge of most recent COP's, PDGM regulations and ensures department compliance.

  1. Seeks clarification from clinicians, physician and others as needed to complete coding and OASIS reviews. Collaborates with Oasis Specialist.

  2. Reviews and analyzes clinical documentation for home health services to assign accurate and compliant ICD-10 codes.

  3. Meets the regulatory, contractual and fiscal month end time frames for documentation submission and month end billing close.

  4. Works with Management team to assure regulatory and certification compliance at local, state, and federal levels.

  5. Completes, updates, and maintains referral log and census reports.

  6. Immediately informs Administrator/DOPS of any issues.

  7. Monitors IDT conferences are being completed and documented.

  8. Performs discharge, patient record review to assure all documentation is in order prior to billing.

  9. Performs performance improvement activities as appropriate to position. Chart Review, Hospitalizations, Hospice Referrals, Admits and Discharges.

  10. Prepares and presents quality reports for PAC, on quarterly bases based on the quality improvement plan.

REQUIRED EDUCATION, TRAINING AND EXPERIENCE:

  1. Graduate of a school of Nursing accredited by the National League of Nursing, Bachelor's degree in nursing preferred.

  2. Registered Nurse in the State of Pennsylvania.

  3. Pennsylvania driver's License, current auto insurance and access to a car during working hours.

  4. Home Health experience is required.

  5. Working knowledge of computers/computers programs.

  6. Holds a current CPR card.

  7. Completion of coding class within 3 months.

  8. Certification in coding required within 1 year of completion of coding course. If unsuccessful must register when able to retest for exam until successfully completed.

  9. Complete continuing eduation yearly as required to maintain HCS-D certification

REQUIRED SKILLS AND ABILITIES:

  1. Demonstrate flexibility the confidence to work independently.

  2. Communicate effectively within a team.

  3. Manage time efficiently.

  4. Show concern for the provision of quality services.

  5. Demonstrate skill in nursing practice.

  6. Ability to do public speaking, educational programs and community outreach.

  7. Ability to maintain confidentiality of information.

  8. Basic computer skills

  9. Ability to lift a minimum of 50 pounds.

  10. Ability to push/pull a minimum of 50 pounds.

  11. Excellent interpersonal, communication, and organizational skills.

  12. Excellent phone etiquette.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Work Location: In person

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