Must have COS-C or HCS-O or COQS and HCS-D or BCHHC The Medicare Case Manager / Coder provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information Set (OASIS) documentation for quality and adherence to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are expected to maintain ongoing communication with BAYADA s service offices and assist the company in addressing and meeting business and development goals.

This is a non-clinical role (Note: Clinical opportunities are also available).

Applicants without COS-C or HCS-O or COQS OASIS Certification AND HCS-D or BCHH-C Home Health Care Coding Certification will NOT be considered for this role.

BAYADA Perks:

• This role is fully remote, candidates may be based anywhere in the US
• Base Salary: $62000/year depending on qualifications
• Bonus Opportunity of $500/Quarter based on department metrics
• BAYADA offers a comprehensive benefits plan that includes the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct deposit, and employee assistance program
• To learn more about BAYADA Benefits, click here.

Responsibilities:

• Review clinical information for appropriateness, congruency, and accuracy as it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines.
• Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy.
• Perform final review and lock OASIS.
• Timely review and coding of OASIS documents with productivity maintained at the quarterly target set by the Director of MCM.
• Prevent or decrease the occasion of Medicare denials by assuring proper coding on the plan of care and accurate OASIS documentation.
• Provide support and communication to all disciplines within the service.
• Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home Care Coding, PDGM guidelines and billing related issues.
• Provide ongoing communication with service offices via e-mail, zoom, or telephone (specific to the service office needs).
• Communication with service offices monthly and as appropriate with a focus on documentation trends, star ratings and potential revenue impact.
• Perform related duties, or as required or requested by Manager/Director.

Qualifications:

• Four (4) year college degree preferred.
• COS-C or HCS-O or COQS OASIS Certification (Required)
• HCS-D or BCHH-C Home Health Care Coding Certification (Required)
• Minimum of 1 year experience with coding and OASIS review.
• Knowledge of OASIS, Home Care and Medicare regulations
• Excellent organizational, interpersonal and communication skills
• Process oriented, has meticulous attention to detail, and is able to work as part of a team in a busy, high-energy, fast-paced environment.
• Completion of coding quiz with passing grade as part of the interview process.
• Candidates should be available Monday-Friday from 8:30am-5:00pm.

Medicare, Coder, OASIS Review, Utilization Review, Quality Assurance, Remote, Home Health Coding #LI-Office1 #JoinBayada-RX

As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.

BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities.