OASIS Review & 485 Specialist - PRN

ResMed has always applied the best of technology to improve people's lives. Now our SaaS technology is fueling a new era in the healthcare industry, with dynamic systems that change the way people receive care in settings outside of the hospital–and tools that work every day to help people stay well, longer. We have one of the largest actionable datasets in the industry, creating a complete view of people as they move between care settings. This is how we empower providers–with vital insight to deliver the care people need, right when they need it.

We're also ensuring that our health solutions connect to other companies' networks. Because when objectives align, everyone wins. And as we work today to drive better care and lower costs, we're developing more personalized solutions for tomorrow, utilizing machine learning, intelligent care paths, and predictive protocols. If you are an innovator who wants to make an impact we want to talk to you! We have exciting opportunities supporting Brightree by ResMed and MatrixCare by ResMed!

Expression of Interest

Please note we plan to hire for this role in the near future. Any applications to this job posting are to express interest in possible future openings (no current role is open). Due to this being an expression of interest, there may be a delay in hearing back from our recruiting team.

We are looking to hire an experienced OASIS Review Coding Specialist. This is a remote position that provides flexibility and control over assigned workload. We are seeking a high caliber individual interested in pursuing a rewarding career with a dynamic software company. The OASIS Review Coding Specialist is responsible for performing 485 Review, OASIS Review, and coding duties while providing excellent service levels deserved by all MatrixCare customers. This role reports to the Supervisor of Coding and Review Operations or Manager of Coding and Review Services.

Responsibilities:

• Coding level exceeds (or at minimum perform at required productivity levels equivalent of 8 completed 485 review or 10 completed OASIS Reviews per day for FT employees).
• Extract clinical information from OASIS Assessment as well as a variety of medical records.
• Assign appropriate ICD-10 Code(s) based on medical records according to established procedures and coding guidelines.
• Suggest changes to OASIS responses based on documentation in the medical record according to established Oasis guidance.
• Recommend changes to the 485 locators based on clinical documentation and in accordance with COP’s.
• Works with external coding databases and industry accepted tools.
• Communicate with agencies effectively and provide excellent customer service.
• Work is completed and documented accurately and timely.
• Conducts peer audits as needed/assigned.
• Regularly provides feedback for processes and performance improvement.
• Quickly ascertain customer needs through research and communication and provide quality solutions.

Qualifications:

• Graduate of accredited school of professional nursing and BSN preferred.
• 2 years of home health OASIS/485 review and coding experience.
• 5 years’ experience in home health and/or hospice preferred.
• A thorough education in EMR systems, coding regulations, PDGM and medical terminology with proven coding capabilities.
• Certification in home health coding (HCS-D or BCHH-C in ICD-10).
• Certification in OASIS (COS-C or HCS-O).
• Experience in quality assurance (QA) or case management a plus.
• Experienced in review of the 485 in line with industry and regulatory standards.
• Ability to communicate effectively with agency staff, management, and other members of the team.
• The ability to make clear, decisive clinical decisions.
• Must understand the impact of clinical decisions as it relates to agency operations and financial impact.
• Must have the ability to justify and at times, defend clinical decisions and documentation.
• Exceptional computer, software and typing skills.
• Must have the ability to work independently, with dynamic and changing priorities while meeting or exceeding targeted event quota.
• Skilled in dealing with a high volume of competing tasks in a fast-paced environment. Strong focus on problem-solving initiatives and quick resolution.
• Detail-oriented as proper billing and reimbursement depend on coding expertise.
• Must comprehend the basics of medicine, such as anatomy, physiology, diseases, and diagnoses. This knowledge is essential for coders, as they will be required to accurately translate medical jargon into code.
• Organized, efficient and precise with strong communication and liaison skills, dependable and hard working with extensive background in quality customer support.
• Must comprehend the basics of home health and hospice business operations, insurance claims processes, and basic office procedures.

Joining us is more than saying “yes” to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.