Overview
DELTAV AUTOMATION ENGINEER Jobs in Indianapolis, IN at Réalta Technologies (RT)
Job Title/Position: Live QA Specialist
Reports To: Director of Quality & Clinical Outcomes
Job Location: Remote from Home
JOB DESCRIPTION SUMMARY
Provides coding expertise to Agencies assigned for ICD-10 coding, reviewing OASIS, Plan of Care review, process & outcome measures, Star Rating items and all pertinent documentation to ensure accurate coding for each patient and ensures that all applicable Federal laws are followed. Applied knowledge of medical terminology, disease processes, and pharmacology required. This individual will be required to make independent decisions regarding accurate ICD10-CM code assignments, OASIS and Plan of Care (POC) recommendations. The Coder review will play a key role in determining the reimbursement potential of Pinnacle Home Care to which they are assigned and adherence to coding standards and regulations and corporate policies developed to ensure accurate billing.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
Performs centralized coding for Pinnacle Home Care agencies via scanned medical records and clinician documentation via EMR data.
Provides Home Health coding, OASIS, POC and quality review for assigned agencies. Able to make independent decisions regarding accurate ICD-10-CM coding and OASIS, POC and quality data assignments
Reviews records, recommending changes for clinician review and acceptance, based on CMS regulation, industry standards and coding convention as supported by documentation
Reviews plan of care for accuracy and quality and make needed recommendations
Applies knowledge of medical terminology, disease processes, and pharmacology.
Assess/review assessments for coding accuracy based on documentation, CMS regulations and coding conventions, OASIS compliance and Plan of Care quality and accuracy
Maintain minimal productivity number standards daily.
Codes all assessments using ICD-10-CM (SHP, and Decision Health Coding Pro software) as well as appropriate industry references
Consults Team Lead and/or Director of Quality & Clinical Outcomes and works out difficult codes and/or coding problems as needed
Attend/participate in continuous learning and education in ICD-10 coding, OASIS, Quality and Plan of Care development as necessary. Keeps abreast of regulatory changes and communicates these changes to Director of Quality & Clinical Outcomes, Coding
Meet or exceed minimum auditing and productivity scores for coding quality and compliance. Maintain quality of coding review with a score of 93% or greater on monthly and/or quarterly quality audits
Plan, prioritize, organize and complete work to meet established objectives.
Should be good steward of all company financial resources, including but not limited to arrangements for equipment and other necessary items and services needed.
Performs duties in accordance of, and under the direction/supervision, as defined by the company organizational chart.
Assists on a variety of special projects and other duties as needed.
Follows agency policies and procedures. Maintains confidentiality of patients and agency information per HIPPA requirements
Completes and submits all documentation in a timely manner according to department policy.
Attends in-service and education as required
Adheres to Federal/State guidelines rules regulations, statutes and law.
Follows the Code of Conduct policy
Complies with corporate and departmental policies and procedures.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job related tasks other than those stated in this description. Incumbents must be compliant with conditions of participation for the Center for Medicare/ Medicaid Services.
POSITION QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Licenses/Certifications:
Formal clinical background required, RN preferred, with current state nursing licensure. Nationally accredited Coding ICD-10 certification required and maintained yearly.
Nationally accredited OASIS- certification required and maintained yearly.
Valid driver’s license and auto insurance
Must complete required departmental competencies to validate and maintain competency
Computer Skills:
To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet software and Database software. Must be proficient in the use of a PC, web-based portals and Microsoft Office Suite (Access, Excel, Outlook, Power Point and Word). Knowledge of SHP and/or Decision Health Coding Pro is a plus.
Education/Experience
Education:
Associates degree or greater in a clinical program required with formal clinical background required, RN license required.
Experience:
Minimum of three (3) years on-going coding and abstracting experience in ICD-10-CM for Home Health agencies preferred. Clinical home health experience preferred. Experience with OASIS analysis preferred.
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Title: DELTAV AUTOMATION ENGINEER
Company: Réalta Technologies (RT)
Location: Indianapolis, IN
