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Optimal Care

Delivering the Science of Care and the Art of Caring

Quality Assurance Coder

QA EngineerQA EngineerFull TimeRemoteSeniorTeam 501-1,000Since 2019Company SiteLinkedIn

Location

Ohio + 3 moreAll locations: Ohio, Michigan, Mississippi, Texas

Posted

16 hours ago

Salary

$21 - $30 / hour

Seniority

Senior

High School3 yrs expEnglish

Job Description

• Apply accurate ICD-10-CM diagnosis codes based on patient conditions and disease processes in accordance with current coding guidelines • Review and validate Face-to-Face documentation for Home Health and Hospice to ensure regulatory compliance • Identify the appropriate focus of care for Home Health and confirm eligibility criteria for Hospice patients • Audit medical records using critical thinking skills to ensure documentation accuracy and compliance • Communicate significant findings, compliance concerns, or documentation discrepancies to the Director of Quality Assurance and QA Specialists • Assist in tracking documentation and coding to support timely billing and regulatory adherence • Prepare reports as directed by the Director of Quality Assurance • Monitor and stay current on Conditions of Participation (CoPs) and regulatory changes impacting quality improvement and patient care • Ensure compliance with federal, state, local, Medicare, Medicaid, third-party payer, and OSHA regulations • Identify and report potential coverage or reimbursement concerns • Manage workflow, recognize sequencing issues, and recommend solutions to prevent disruption to patient care • Assist with special audits and quality initiatives as assigned

Job Requirements

  • High School Diploma or GED
  • Current ICD-10 Coding Certification
  • Minimum 3 years of quality assurance experience
  • Demonstrated interpersonal skills with ability to communicate effectively
  • Demonstrated decision making and financial management skills
  • Exhibits working knowledge of regulations and reimbursement in home health and hospice
  • Willing to develop new critical thinking skills

Benefits

  • Minimum of 3 Weeks Paid Time Off (PTO)
  • Company Vehicle Program
  • Mentorship Culture
  • Medical, Dental, and Vision Insurance
  • 401(k) with Employer Match
  • Mileage Reimbursement
  • Cutting Edge Technology

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