Medical Review and Coding Specialist Home Care AdventHealth Corporate
Location Address: Remote
Top Reasons To Work At AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday – Friday
You Will Be Responsible For:
Completes accurate coding for assigned agencies utilizing the agency’s EMR and any “scrubbing” software to assess clinical records and apply appropriate ICD-10-CM codes.
Reviews clinician documented OASIS and draft Plan of Care/485 and returns recommendations of edits to the clinician completing assessment and clinical supervisor/PI of agency. Resources CMS regulations, industry standards and coding convention as supported by clinical documentation.
Provides clear written recommendations related to changes to plan of care following review of clinical documentation, referral information and documents from hospital/physician office.
Identifies trends related to OASIS review, including those that could impact the agency’s outcomes and/or process measures and shares with manager.
Maintain quality of coding review with score of 95% or greater on ongoing quality audits.
Attends/participates in ongoing learning and education in ICD-10 coding, and industry and regulatory changes
Adheres to federal/state guidelines, rules and regulations, statutes and law.
Utilizes time management skills to achieve daily productivity standards and documentation submission requirements.
Ability to mentor and/or train other team members related to medical review and coding functions
Flexibility as may be asked to work on additional projects
What You Will Need:
At least 2 years home care experience in a Certified home care agency
Experience in diagnosis coding of home care records including OASIS review
Current RN, PT, OT, or ST license in the state of residence, preferred
Background in management, operations, or quality assurance in a home care agency, preferred
Hospice experience, preferred
One of the following coding certifications:
Home Care Coding Specialist: Diagnosis (HCS-D)
Board Certified Home Health-Coding (BCHH-C)
AND one of the following OASIS certifications:
Certificate for OASIS Specialist – Clinical (COS-C)
Home Care Clinical Specialist – OASIS (HCS-O)
Other National coding or OASIS certifications may be considered
AdventHealth Central Billing Office (CBO) provides coding and medical review services for system-wide home care and hospice agencies. The Home-Based Services (HBS) Medical Review and Coding Specialist is responsible for reviewing and analyzing documentation present in the medical record to assign diagnoses codes as described by the physician(s) of record. Evaluates patient data, and consistency of OASIS documentation and assessments to ensure appropriateness, completeness, and compliance with federal and state regulations. Ensure appropriate ICD-10CM coding and sequencing and works with clinical staff to clarify and correct documentation and data integrity issues as they relate to coding, OASIS, plan of care and other regulatory requirements
Applies current coding guidelines, implements regulatory changes, obtains additional and/or clarification of documentation from physicians and clinical staff via clerical admin department to assure documentation supports diagnoses coded.
The employee must be able to function with a high degree of independence and considerable discretion as work may be completed onsite or remotely.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.