Sr. QA Reviewer

Compliance and Documentation: Require thorough documentation to support the services provided and justify reimbursement. The team ensures that all documentation follows regulatory requirements and assists clinicians and caregivers in maintaining accurate records. QA Clinician is responsible for auditing patient/client and employee records for compliance with established agency policies and procedures, federal, state, and local regulations for home care as well as CHAP standards. Completes review process in a timely, organized manner that allows smooth process flow from visit to billing. (a) Oversees the quality and timeliness of clinical documentation to ensure reimbursement for service by Medicare and other third-party payers (b) Reviews, corrects, completes, and locks OASIS documentation in accordance with federal guidelines and company policy. (c) Assists with OASIS transmission process, to include review of assessment errors and Final Validation Reports (d) Reviews, corrects, completes, and approves physician orders in accordance with federal and state regulations and company policy; confirms appropriate problem identification and Plan of Care development, including disciplines, frequency and duration of planned services Requirements Graduate of bachelor’s in science (Nursing, Physical Therapy, and other healthcare related degree) The candidate should have at least 1year experience in Medical Coding, Clinical Documentation and Navigating Electronic Health Record.