Immediate Joiners - Home Health coding(Experienced )

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

Job Summary:

Home Health Clinical Reviewer

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 accuracy and quality of OASIS submissions.

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

• Review POCs for regulatory compliance, patient-centered 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

  23 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).

sofia@zealousservices.com