Rejection Home Health Reviewer
Position Summary :
This position provides the review of agency rejections for the coding division to ensure quality of coding services offered by The Corridor Group. Works collaboratively with the Denial and Rejection Team Leader to communicate identified issues.
The Rejection Home Health Reviewer serves as an expert resource to staff and clients in ICD-10 coding and OASIS review while also assuming responsibility for review of rejected records, correcting identified errors and/or providing education to coders and/or clients, as appropriate to ensure compliance with regulatory and accrediting rules and regulations.
Job Location: Anywhere in the United States. This role is eligible for work-from-home status. The majority of current Corridor staff work remotely, from their homes.
Essential Duties and Responsibilities :
To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Conducts review of records identified as “rejected” by client.
- Makes corrections to coding and/or OASIS recommendations as appropriate.
- Communicates findings and actions taken to the client.
- Accurately categorizes and records rejections by type for data reporting and tracking of trends.
- Provides education to coders when coder errors identified.
- Provides education to client as appropriate.
- Communicates global education needs related to rejections to Educators
- Provides education and mentoring to coders with ICD-10 coding and OASIS reviews.
- Serves as a proactive member of The Corridor Group team in support of improving the performance of coding services.
- Maintains expert current knowledge of ICD-10 coding guidelines, OASIS assessments and regulations.
- Proactively identifies issues/concerns and requests assistance up-line as required.
- Establishes professional and positive relationships with clients through timely and effective client communication
- Establishes professional and positive work environments by modeling respect and dignity toward all employees and acknowledging the value of individual’s effort and contributions.
- Abides by and demonstrates the company Mission-Vision-Values through both behavior and job performance on a day-to-day basis.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- At least four years related experience and/or training; or equivalent combination of education and experience.
- Previous Home Care Coding experience required.
Certificates and Licenses:
- Coding Credential (HCS-D or equivalent) required
- OASIS Credential (COS-C or equivalents) required
- ICD-10 Certification required
- Microsoft Office Applications - intermediate skill required.
- Proficiency in EMR navigation with ability to protract needed data for coding, OASIS, and other comprehensive reviews.