- 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.
- 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.