Status: Full Time
The OASIS Review Specialist is a Registered Nurse with certifications in OASIS (COS-C) and ICD-10 coding (HCS-D) and is responsible for reviewing OASIS documents in relation to home health services. He/she performs detailed review of clinical assessment documentation including, but not limited to Start of Care, Resumption of Care and Recertification to ensure appropriateness, completeness, and compliance with state and federal regulations.
- Performs detailed review of clinical assessment documentation including, but not limited to Start of Care, Resumption of Care and Recertification to ensure appropriateness, completeness, and compliance with state and federal regulations.
- Assures that documentation, coding, and OASIS responses are consistent with the patient’s condition and the reason for services provided.
- Assures correct reimbursement for services provided.
- Performs client chart audits.
Maintains current knowledge of OASIS assessment and ICD-10 coding.
- Notifies agency leadership of problematic trends in OASIS documentation.
- Consults with clinical staff.
Provides educational guidance to staff on code selection, OASIS response, documentation and Plan of Care development.
- Other duties/projects as assigned.
- Must be a registered nurse (RN) in the State of Texas, Oklahoma (OK) or Louisiana (LA).
- Must have current certifications in OASIS (COS-C) and ICD-10 (HCS-D).
3 years of home health experience required.
- Knowledge of Medicare, private insurance, and Medicaid requirements.
- Knowledge of federal and state licensure requirements.
- Experience with quality and utilization review preferred.
- Experienced with Home Base Home Care preferred.
- Knowledge of Home Health Compare and outcomes trending.
Skills & Abilities:
- Have working knowledge of electronic medical health records and computer systems.
- Have the ability to motivate others in a positive manner.
- Have excellent verbal and written communication skills.
- Possess well developed interpersonal skills.
- Have the ability and personal discipline to organize work and schedule effectively while working from home.
- Be willing and able to foster the team and continuous quality improvement concepts.
- Have a general knowledge of computers.
- Have the ability to think analytically.
Posted on Thu, October 29, 2015
by Jordan Health Services