Home Health Clinical Reviewer – ICD-10, OASIS-E, POC (Level 2 & 3)

Job Summary:

We are seeking an experienced and detail-oriented Home Health Medical Coder with expertise in ICD-10 coding, OASIS-E assessments, and Plan of Care (POC) reviews at Levels 2, 2.5 and 3. The ideal candidate will ensure accurate clinical documentation, regulatory compliance, and optimal reimbursement through precise coding and thorough review of patient records. This role plays a critical part in maintaining quality care standards while supporting operational efficiency in our home health program. 

Key Responsibilities:

1. ICD-10 Coding:

• Assign accurate ICD-10-CM diagnosis codes for home health episodes in accordance with CMS and agency guidelines.
• Ensure coding supports medical necessity and aligns with the Plan of Care.
• Validate primary and secondary diagnoses for accuracy and compliance. 

2. OASIS-E Review

• Review OASIS-E assessments for completeness, accuracy, and compliance with CMS guidelines.
• Identify and correct inconsistencies in assessment data and documentation.
• Provide feedback to clinicians to improve the accuracy and quality of OASIS submissions.

3. Plan of Care (POC) Review – Level 2 & 3

• Review POCs for regulatory compliance, patient-centred goals, and accurate service frequency.
• Ensure care plans reflect patient needs, functional status, and physician orders.
• Collaborate with field clinicians to resolve discrepancies and clarify orders.

4. Quality & Compliance

• Maintain up-to-date knowledge of CMS regulations and PDGM requirements.
• Perform internal audits of documentation to ensure compliance and accuracy.
• Support clinical staff education on documentation and coding best practices.

Qualifications & Requirements:

• Minimum 1–3 years in home health coding, OASIS review, and POC preparation.
• Strong understanding of PDGM and CMS compliance requirements.
• Proficient in ICD-10-CM coding guidelines and sequencing rules.
• Expertise in OASIS-E data sets and scoring.  Detail-oriented with strong analytical and problem-solving skills.  Excellent communication and collaboration skills.
• Proficiency with EMR/EHR systems (e.g., Kinnser, HCHB).

Work Environment:

• Location: On-Site
• Schedule: Full-time; flexible scheduling may be available

Why Join Us?

• Competitive salary and benefits package
• Collaborative and supportive team culture
• Opportunity to contribute to high-quality patient care in a growing home health organisation