Facility: VIRTUAL-GA

Job Summary:

The Quality Assurance Coordinator is responsible accurately and completely assigning appropriate diagnosis and codes, reviewing the clinical documentation of the field clinicians which includes 485s, Oasis, daily notes, and final claims. The Coordinator assists in education and orientation of the staff. The Coordinator also assists with auditing as assigned, PI projects, transmitting data to the state. The Coordinator is knowledgeable of federal, state, and local laws and regulatory guidelines related to billing and documentation.Coordinator is certified in OASIS and appropriate coding.

Core Responsibilities and Essential Functions:

DocumentationReview/Coding * Accurately and completely assigns appropriate diagnosis and codes * Reviews and ensures 485s are correct and completed timely * Reviews OASIS for completion, congruency and accuracy * Generates HRRG score for RAPS * Audits and reviews final claims for release to billing * Works with Accreditation Coordinator on special projects, ensures accurate audits and assists with development of action plans as needed Staff Review and Education * Reviews documentation with Clinicians 485s, daily notes, OASIS timepoints * Educates Clinicians on the appropriate way to complete OASIS timepoints * Participates in orientation of new Clinical employees on OASIS documentation * Assists in orientation of Clinical staff on Medicare Guidelines * Attends team meetings to present documentation findings * Assists on committees for education i.e. wound care, etc Regulatory * Maintains current knowledge of federal, state, and regulatory guidelines related to billing, documentation, and coding * Maintains knowledge of Medicare regulation and Conditions of Participation * Transmits OASIS data to the State * Maintains certification in OASIS and appropriate Coding ie.ICD9 and ICD 10 Customer Service * Maintains a positive working relationship with all Wellstar Homecare departments and Clinical staff * Serves as resource to Clinical staff and Managers Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• Bachelors Nursing or Accredited Program Nursing

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• Reg Nurse (Single State) or RN - Multi-state Compact

Additional License(s) and Certification(s):

OASIS Certification and ICD10 Certification recommended. Required

Required Minimum Experience:

Minimum 3 years Minimum of 3 years Home Health experience. Required and Previous Home Health QA experience Preferred

Required Minimum Skills:

Professional, independent and self directed. Must possess excellent customer service skills and communication skills both written and verbal. Strong organizational skills with the ability to multi-task in a fast paced environment. Must have excellent computer proficiency