Oasis Reviewer
Posted 7ds ago
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Job Description
OASIS Reviewer ensuring compliance and data integrity for Home Health documentation. Collaborating with clinicians and reviewing assessments for accuracy and completeness.
Responsibilities:
- Prospectively review all OASIS assessments to ensure appropriateness, completeness, and regulatory compliance.
- Evaluate OASIS data for internal consistency, accuracy, and alignment with patient condition and care delivery.
- Utilize OASIS variation, validation, or alert reports to identify potential data integrity concerns.
- Ensure documentation supports accurate clinical representation and compliant reimbursement.
- Partner with clinicians and agency staff to clarify documentation discrepancies or data integrity issues.
- Provide guidance to clinicians on appropriate corrections in accordance with agency policy and regulatory standards.
- Support education and reinforcement of best practices related to OASIS completion and assessment accuracy.
- Review visit utilization for alignment with patient condition, plan of care, and clinical guidelines.
- Identify and report potential underutilization, overutilization, or financial risk to the Coding and OASIS Manager, Clinical Manager, or designee.
- Escalate trends that may impact reimbursement, outcomes, or compliance.
- Identify and communicate problematic trends or recurring issues identified through OASIS review.
- Participate in Quality Improvement and Corporate Compliance initiatives as assigned.
- Assist with additional chart audits or documentation reviews as needed.
- Maintain current knowledge of OASIS standards, regulatory changes, and industry best practices.
- Demonstrate and uphold CAPLICO values in all interactions and work practices.
Requirements:
- Working knowledge of the OASIS data set and assessment process.
- Strong understanding of federal regulations and state licensure requirements for home health.
- Knowledge of the legal and regulatory framework governing the home health industry.
- Ability to work independently while maintaining strong collaboration with interdisciplinary teams.
- Excellent written and verbal communication skills.
- Strong computer proficiency, including Microsoft Outlook and agency documentation systems.
- Valid driver’s license, vehicle insurance, and access to reliable transportation or public transportation.
- At least two (2) years of home health clinical, coding, or billing experience (preferred).
- OASIS certification (COS-C) (preferred).
Benefits:
- Professional development
- Ongoing education through workshops and training
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