About the role
Job Summary
We are seeking a highly motivated and detail-oriented OASIS/CODING/QA SPECIALIST to join our dynamic healthcare team. In this pivotal role, you will be responsible for ensuring the accuracy and compliance of patient data through meticulous coding, quality assurance processes, and adherence to healthcare regulations. Your expertise will support the delivery of high-quality patient care, optimize billing processes, and maintain regulatory compliance across various healthcare settings. This position offers an exciting opportunity to contribute to process improvements, uphold industry standards, and advance your career in healthcare compliance and coding.
Responsibilities
- Review and accurately assign CPT (Current Procedural Terminology), ICD-9, and ICD-10 codes, ensuring precise documentation for billing and reporting purposes.
- Knowledgeable in Axxess
- In-office position, Delray Beach, Florida
- Certified HSC-D, HSC-O, COS-C, or similar as an OASIS coding specialist
- Check SOC, ROC, and recertification documents for clinical accuracy
- OASIS review and start of care
- Medicare star rating monitoring and management
- Certification preparation
- QA review
- Releasing the chart to billing
- Conduct comprehensive audits of electronic health records (EHR) to verify data integrity, coding accuracy, and compliance with HIPAA and CMS regulations.
- Ensure adherence to healthcare accreditation standards such as JCAHO by implementing quality assurance protocols and process improvements.
- Maintain up-to-date knowledge of healthcare laws, including HIPAA, FDA regulations, medical law, and Medicare policies, to ensure ongoing compliance.
- Collaborate with interdisciplinary teams to streamline workflows related to OASIS (Outcome and Assessment Information Set) data collection and management.
- Lead or participate in projects aimed at process improvement, data analysis, and risk management initiatives within the organization.
- Utilize Axxess, Microsoft Office tools, and Google Workspace proficiently for documentation, reporting, and data analysis tasks related to healthcare compliance and quality assurance.
Experience
- Proven experience in medical coding (CPT, ICD-9/10) with a strong understanding of healthcare reimbursement systems such as Medicare and managed care plans.
- Demonstrated knowledge of healthcare compliance standards, including CMS regulations, JCAHO accreditation requirements, and FDA guidelines.
- Prior experience in quality assurance or quality improvement within a healthcare setting is highly desirable.
- Strong project management skills with the ability to lead initiatives that enhance process efficiency and regulatory compliance.
- Familiarity with electronic health records (EMR/EHR management systems), data analysis tools, and medical terminology is essential.
- Excellent understanding of healthcare laws related to risk management, patient privacy (HIPAA), and accreditation standards.
- Ability to work collaboratively within multidisciplinary teams while demonstrating leadership qualities in managing compliance projects.
Join us in this vital role where your expertise directly impacts patient safety, regulatory adherence, and operational excellence!
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