Coding specialist Jobs in Plano, TX

EMPOWER SERVICES - OASIS Coding Specialist PRN

About Us:

At Empower, we are proud to serve as a one-stop-shop business partner for healthcare organizations to support their administrative and employer needs. We strive to be more than a workplace, but also a community, where every voice is heard, and every team member is valued. Our team is driven by a shared mission to create a positive impact on healthcare organizations and the lives they touch. Join our team today to be part of our mission!

Job Summary:

Accurate and timely coding and review of home health OASIS assessments and plan of care to ensure compliance with CMS regulatory guidelines, optimize reimbursement, contribute to overall quality improvement efforts, and manage visit utilization.

Essential Functions:

1. Review and analyze OASIS assessments completed by clinicians to ensure accuracy, completeness, and compliance with regulatory requirements.
2. Assign appropriate ICD-10 diagnosis codes based on referral paperwork and OASIS assessment data.
3. Conduct face-to-face documentation review to ensure documentation supports the medical necessity of home health services and meets CMS requirements.
4. Collaborate with interdisciplinary teams including nurses, therapists, and physicians to resolve discrepancies and ensure comprehensive documentation.
5. Stay updated with changes in coding guidelines, regulations, and industry best practices related to home health care coding and reimbursement.
6. Provide training and education to clinical staff on OASIS documentation requirements, Value Based Performance, and quality improvement initiatives.
7. Maintain confidentiality and integrity of patient health information in accordance with HIPAA regulations and organizational policies.
8. Review and assess the plan of care to ensure alignment with OASIS assessments, coding guidelines, and regulatory requirements.
9. Demonstrate knowledge and experience with pre-claim review processes to support accurate and compliant claims submission.
10. Manage visit utilization by reviewing visit frequencies, durations, and documentation to ensure appropriateness and compliance with payer guidelines.

Additional Responsibilities:

1. Performs other duties as assigned or requested.
2. Conforms to all applicable Agency policies and procedures.
3. Sound clinical judgement and ethical decision-making.
4. Participates actively in continuing education and in-services.
5. Maintains confidentiality of patient information and business trade practices

Knowledge / Skills / Abilities:

1. Excellent organizational and interpersonal communication skills
2. Able to perform and prioritize multiple functions or tasks
3. Time management
4. Cooperative attitude
5. Extensive knowledge in CMS guidelines/regulations, Value Based Purchasing, and Pre-Claim Review.
6. Experience performing OASIS reviews using Homecare Homebase (HCHB).
7. Excellent analytical skills and attention to detail to accurately abstract and assign ICD-10 codes from complex clinical documentation.
8. Strong communication and interpersonal skills to collaborate effectively with multidisciplinary teams and physicians.
9. Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
10. Work is completed and documented accurately and timely with high quality.
11. Regularly provides feedback for process improvement.

Information Management:

Treats all information and data within the scope of the position with appropriate confidentiality and security.

Risk Management:

· Cooperates fully in all risk management activities and investigations.

· Keeps abreast of changes in health care law.

· Maintains Agency/program compliance with local, state, and federal laws as well as state accreditation standards.

Minimum Position Qualifications:

· Education:

High School Diploma or GED

· Experience:

Minimum of 2 years’ experience in home health care coding and OASIS review.

· License / Certification:

Driver’s license and proof of current auto liability insurance; no listing in the OIG Excluded Provider listing

Certification as a Home Health Coding Specialist (HCS-D)

Certification as OASIS Specialist (COS-C) or Homecare Clinical Specialist (HCS-0)

Environmental Conditions:

Works under a variety of conditions in facilities and offices; ability to work flexible schedule, ability to travel locally; some exposure to unpleasant weather. Moderate noise level; tasks may involve exposure to bloodborne pathogens; moderate stress and emotional demands.

Physical Requirements: Sitting is required. Requires ability to always handle stressful situations in a calm and courteous manner. Requires working under some stressful conditions to meet deadlines and agency needs. Ability to travel by car or plane.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities.