PruittHealth Episode Assessment Coordinator - OASIS Coding in Norcross, Georgia

Category : Home Care

Location/City : GA - Norcross

Id : 22652

Title: Episode Assessment Coordinator & OASIS ReviewerLocation: PruittHealth Home Care Home Office- Atlanta, GAPOSITION SUMMARY:Under the supervision of the Director of Episode Assessment Coordination (DEAC), the Episode Assessment Coordinator (EAC) is responsible for prospective review of episode related documents, ensuring all services and documentation meet the organizations standards for service delivery that is appropriate, adequate, effective and efficient, and meets all state and federal guidelines. The EAC in prospective review also ensures service utilization meet needs for improved patient outcomes and appropriate claims reimbursement according to regulatory billing guidelines.ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Performs prospective review of Referrals, History and Physicals, Orders, medication profiles, homebound statements, interventions and goals and OASIS assessments to include: Start of Care (SOC), Resumption of Care (ROC), Recertification (Recert), Transfer (TSF) and Discharge (D/C) to ensure appropriateness, completeness, accuracy and compliance with all state and federal regulatory and accreditation guidelines. Ensures appropriate sequencing and ICD-10 coding on the Physician's Plan of Care ( POC) as it relates to the patient's medical conditions, including any co-morbidities and current guideline requirements and conventions, Consults with the appropriate clinician to clarify any data integrity issues and/or corrections to documentation; documents same in the electronic medical record (EMR), Assists clinicians in establishing goals, setting priorities and in ensuring appropriate data elements are included in the (POC), Reviews visit utilization for appropriateness as per care guidelines and, best practices and patient condition; reports potential financial losses and/or underutilization to the Clinical Manager or designee. Stays informed about changes in the home health care industry, including state and federal regulations, accreditation requirements. Attends education sessions as assigned and shares that information with agency staff as appropriate, Works closely with corporate OASIS Reimbursement Coordinator (ORC) for any subject matter expertise required, identification of audit results/trends identified and works with ORC to educate and monitor staff improvement as necessary to improve audit outcomes, Works closely with the agency Clinical Manager other office peers, to proactively address all service delivery documentation requirements for the most effective revenue cycle management possible, coordinates episode planning with the CM to assure accuracy of the HHRG scores upon admission and recertification, Works closely with agency clinicians regarding timely acceptance or decline of recommended changes in the clinical record and locking the OASIS with company processes and/or escalates identified needs to achieve this to agency supervision and DEAC.LICENSURE, CERTIFICATION, EXPERIENCE AND EDUCATION REQUIREMENTS: Bachelor Degree in Nursing preferred, Multi-State Nursing RN licensure in SC, NC and or GA. OASIS certified preferred or in process Home Health experience highly preferred. Demonstrated knowledge of clinical record review processes, ICD-10 coding requirements and OASIS C2 conventions to ensure accurate documentation prior to request for anticipated payment preferred. Demonstrated knowledge of accreditation, federal regulations and state licensure requirements for home health service delivery, and also federal interpretive guidelines and billing requirements for documentation for episodic and private insurance payers preferred. Experience working in Home Care Home Base (HCHB) and Strategic Healthcare Partner (SHP) software applications preferred.For immediate consideration, please click the "Apply Now" at the top right of this screen.We offer a progressive benefits program that reflects our commitment to caring for our 16,000 partners:* Partner Referral Program â Earn cash for referring licensed and certified candidates* Employer paid profit sharing* Employer matching 401(k)* Paid Time Off (PTO) accruals beginning the first day of employment* Access to "Purchasing Power" financial health program after one year of employmentAt PruittHealth, Committed to Caring isn't simply a tagline, it's the way we do business and it's ingrained in our culture. At PruittHealth, we don't hire employees â we welcome partners!Since its inception in 1969, PruittHealth has been a family-owned innovative organization committed to providing exceptional care across a wide spectrum of services including: skilled nursing care, assisted & independent living, home health care, end-of-life hospice care, rehabilitation, pharmacy/infusion services and more.

Today, the organization is the 14th largest skilled nursing provider in the United States, spans across the Southeast, touches 170 communities, cares for 24,000 patients daily, and is driven by 16,000 passionate partners.PruittHealth is an Equal Employment Opportunity employer and all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability or veteran status.