Medical Review/Coder Nurse
Position Requirements: NYS RN License required. A minimum of Associates Degree in Nursing required, Bachelor's Degree preferred. Must have a minimum of three years RN experience with 2 years experience in a Certified Home Health Agency. Must have a working knowledge of PPS, OASIS, computer systems, and health insurance plans (i.e., Medicare, Medicaid, and Blue Cross). OASIS AND Home care Coding Certification preferred.
Position Responsibilities: Proactively reviews Medicare beneficiary records and third party payors to evaluate the services ordered and to determine whether the POC supports the need for these services. Processes all information and provides documentation needed to support findings and assists in the proper reporting of these services. Reviews all OASIS and related documentation to assure accuracy, consistency, and regulatory compliance. assigns ICD-9 coding and sequencing to obtain timely and maximum reimbursement.