Certified Home Health Coder & QA Specialist

Position Overview

Certified Home Health Coder & QA Specialist is responsible for coding using ICD-10 for all diagnoses and applicable procedures of skilled service visits. This role requires expertise in PDGM, Oasis D1, and proficiency with Kinnser software. In addition, the specialist reviews OASIS and abstracts visit data for billing and data collection purposes.

Key Responsibilities

• Codes records using ICD-10-CM and established coding guidelines.
• Reviews OASIS documentation.
• Observes and reports unusual patterns in data collection and/or inadequate documentation.
• Provides ICD-10 coding recommendations based on current coding and OASIS guidelines.
• Performs other related duties as requested by Home Health Supervision.
• Maintains open communication with management/supervisors using high-tech communication modules.

Required Qualifications

• Certification in Home Health Coding is required.
• Working knowledge of CMS Condition of Participation in Home Health Services.
• Familiarity with federal and state home health licensure regulations.
• Proficiency in medical terminology, anatomy and physiology, compliance, and reimbursement guidelines.
• Sound computer skills and adaptability to home health documentation software.
• Detail-oriented with strong analytical, critical thinking, and interpersonal skills.
• Ability to adjust to unexpected changes in work volume and schedule.
• A minimum of two years of experience with ICD-10 and/or ICD-9 coding.
• Minimum 5 years of Medical Coding experience and 2 years of ICD-10 experience.
• A high school diploma and completion of coding-specific coursework.
• Strong commitment, reliability, superb communication, and computer literacy (including Excel, web-browsers, email, and electronic health records).

Preferred Qualifications

• Proficient knowledge of OASIS.
• Registered Nurse credential (or preference for RN candidates).
• A college diploma or degree from an accredited nursing or healthcare program.
• Registered Nurse License in Michigan.
• Additional healthcare-related abstraction and coding credentials.