home health qa nurse with medical coding experience ( Work From Home)TSG Outsourcing

How to Apply:
Copy and Paste the Link below in the browser to generate the application form:
https://forms.gle/UwbRCBTnF6WVuuRP8
 
Rate: $5/hr and earn up to PHP 50,000+/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 notes
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 notes with necessary data
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 notes with necessary data