PRN 1099 Oasis Reviewer and Home Health Coder

Job Summary We are seeking a dedicated and detail-oriented PRN 1099 OASIS Reviewer, Home Health Coder, and Plan of Care (POC/485) Specialist to join our dynamic healthcare team. In this role, you will be responsible for reviewing OASIS assessments, accurately coding home health services, and reviewing and/or developing physician Plan of Care (POC/485) documentation to ensure compliance with CMS regulations, payer requirements, and industry standards. Your expertise will support accurate patient care documentation, optimize reimbursement processes, facilitate timely physician orders and care plan management, and uphold the highest quality of medical record integrity. The ideal candidate will possess strong clinical knowledge, exceptional attention to detail, and the ability to work independently in a fast-paced environment. This flexible position offers the opportunity to make a meaningful impact on patient care documentation and agency compliance while working remotely. Candidates must be logged in and actively available on Microsoft Teams during normal business hours (Eastern Standard Time) to support communication, collaboration, and workflow needs. Duties

• Review OASIS assessments thoroughly to verify completeness, accuracy, and compliance with CMS regulatory guidelines.
• Apply appropriate ICD-10 coding to ensure accurate clinical documentation, reimbursement, and compliance.
• Analyze medical records and clinical documentation to assign correct diagnoses and facilitate accurate billing processes.
• Review, develop, and update Plan of Care (POC/485) documentation to ensure physician orders, diagnoses, interventions, goals, frequencies, and services are accurately reflected and compliant with Medicare Conditions of Participation.
• Coordinate with clinicians, physicians, and intake staff to obtain clarifications and ensure timely completion and certification of POC/485s.
• Perform comprehensive chart audits to ensure consistency between OASIS assessments, physician orders, visit documentation, and the Plan of Care.
• Collaborate with home health clinicians, clinical managers, and billing teams to resolve documentation discrepancies and improve overall documentation quality.
• Review recertifications, resumptions of care, transfers, and discharges for coding and regulatory compliance.
• Maintain up-to-date knowledge of CMS regulations, OASIS guidance, ICD-10 coding updates, PDGM requirements, and home health reimbursement methodologies.
• Utilize WellSky EMR to review, edit, manage, and audit clinical documentation, coding, and Plan of Care workflows.
• Ensure all coding and documentation activities support proper reimbursement while adhering to legal, ethical, and compliance standards.
• Generate detailed reports on coding accuracy, review outcomes, compliance metrics, and quality improvement initiatives for management review.

Experience & Qualifications

• Required: Minimum 2 years of home health OASIS review and ICD-10 coding experience.
• Required: Extensive experience with WellSky EMR (formerly Kinnser).
• Strong knowledge of Medicare home health regulations, Conditions of Participation, PDGM, and OASIS-E requirements.
• Demonstrated experience reviewing, creating, and auditing Plan of Care (POC/485) documentation.
• Thorough understanding of ICD-10 coding guidelines, medical terminology, anatomy, physiology, and disease processes.
• Familiarity with home health billing, reimbursement processes, and medical records management.
• Ability to interpret complex clinical documentation accurately and identify documentation deficiencies.
• Exceptional attention to detail, organizational skills, and ability to work independently in a remote environment.
• Strong communication and collaboration skills when working with clinicians, physicians, and interdisciplinary teams.
• Prior experience working remotely and/or in a PRN capacity is highly preferred.
• Coding certification (HCS-D, BCHH-C, COS-C, CPC, or equivalent) is preferred but not required.

Join our team as a vital part of the home health clinical review process, where your expertise in OASIS, ICD-10 coding, Plan of Care management, and WellSky EMR helps ensure documentation excellence, regulatory compliance, and optimal reimbursement. Pay: $30.00 per hour Benefits:

• Referral program

Experience:

• WellSky, HCHB, KanTime, Healthwyse, Axxess, Matrix Care, PCC: 1 year (Preferred)

License/Certification:

• HSC-D (Required)
• HCS-O (Required)
• COS-C (Required)

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