Home Health QA Nurse with Medical Coding Experience ...

Home Health QA Nurse with Medical Coding Experience

Thrive Technologies Inc.

Work from Home

Remote

PHP 407 an hour

-

Full-time

Here’s how the job details align with your profile.

PHP 407 an hour

Full-time

Full job description

How to Apply

Copy and Paste the Link below in the browser to generate the application form:

https://forms.gle/UwbRCBTnF6WVuuRP8

Rate: $6.5/hr and earn up to PHP 70,000+/month

Schedule: Monday to Friday: 1:00 PM - 10:00 PM PST with a 1- Hour Unpaid Lunch Break.

Home Health QA Nurse with Medical Coding Experience (Work from Home)

Qualifications

• Bachelor’s Degree in Nursing and Active PRC license ( HUGE plus if a Registered Nurse in California)
• At least 1 year of experience (home health care or hospice)
• Working knowledge of rehab practices and procedures
• Understanding of therapy treatment plans
• Understanding of ICD-10 coding, especially in the respective field a plus but not required
• Working knowledge of Medicare home health guidelines is a plus, but not required
• Working knowledge of home health and CMS requirements for OASIS and Plan of Care for both clinical and billing needs.
• Ability to comprehend clinical policies and criteria to articulate requirements surrounding health record information.
• Demonstrates proactive identification of problem areas and reports areas of concern to senior management.
• Intermediate computer skills, including Microsoft Outlook, Excel, Word, PowerPoint, and a willingness to learn new information technology, are required.
• Experience with Kinnser EMR Software

Coding Must Have

• ICD-10 CPT home health coding experience required
• Knowledge and ability to audit OASIS and SN/PT/OT/ST/MSW/HHA skilled visit

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• Review OASIS documentation and audit for appropriate coding and skilled documentation
• Knowledge of Medicare guidelines and Conditions of Participation
• Quality Management/Utilization Review and Performance Improvement.
• Proficient in all documentation & record maintenance to ensure accuracy, patient confidentiality & compliance

Responsibilities

• Ensures current and accurate clinical records in compliance with documentation requirements and program-specific rules for coverage and qualifying criteria
• Ensures clinical records are maintained in their original state and not improperly altered or fabricated. Able to perform OASIS SOC/ROC/Recertification reviews of past field staff visits
• Ensure compliance with all Federal, State, and local regulations and standards of practice
• Complies with Medicare, Medicaid, and State license requirements
• Reviews documentation for the necessity of services, quality care, and compliance with physician orders and the plan of care to ensure quality care and reimbursement
• Ensures accuracy of claims by providing necessary services with appropriate physician orders that substantiate a reasonable and necessary service need
• Creates clinical orders for clinicians to review/approve
• Follow up with Doctors' offices to get orders signed within the regulatory timeframe via phone, text, chat, and fax.
• Use electronic faxes to send/receive various documentation from doctors and other sources
• Communicate with field staff via phone, text, and chats. Pre-fill visit

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Coding

• Accurately assign ICD-10-CM codes to diagnoses from the care plans and documentation submitted by the clinicians in EMR
• Follow up with clinicians and other staff to obtain missing or incomplete information
• Perform audits using SHP and PPS Analytics to ensure all OASIS checks are done, and the OASIS submission goes without any errors
• Review and identify errors and report them to a supervisor
• Probe clinicians when code assignments are unclear, or documentation is inadequate, or ambiguous
• Obtain ICD-10 Home Health Certification(HCS-D/BCHH-C) within 90days of hire
• Requires ongoing review and adherence to a multitude of regulatory changing requirements
• Knowledge of reimbursement models applicable to home health; knowledge of anatomy, physiology, disease processes, medical terminology, pharmacology
• Adhere to HIPAA privacy and security regulations and policies
• Perform OASIS SOC/ROC/Recertification reviews of past field staff visits
• Create clinical orders for clinicians to review/approve
• Follow up with Doctors' offices to get orders signed within the regulatory timeframe
• Use electronic faxes to send/receive various documentation from doctors and other sources
• Communicate with field staff via phone, text, and chats. Prefill visit

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• s with necessary data
• Pay: Php407.00 per hour
• Expected hours: 40.0 per week
• Work Location: Remote
• Company and salary information

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