OverviewMedical Review Nurse Coder (Home Health)Job Summary:The Catholic Health Home Care Medical Review Nurse Coder is responsible for ensuring the accuracy, completeness, and regulatory compliance of home health clinical documentation prior to billing. This role reviews OASIS assessments, patient charts, Face-to-Face (F2F) encounters, physician orders, and Plans of Care to support Medicare Conditions of Participation, payer requirements, and timely reimbursement.
Role Impact:This role is essential to maintaining regulatory compliance, ensuring accurate reimbursement, and supporting high-quality, timely patient care in the home health setting.
Job DetailsKey Responsibilities:- Review OASIS assessments for accuracy, completeness, and compliance
- Audit patient records to ensure documentation supports billed services
- Validate Face-to-Face (F2F) encounters for regulatory compliance
- Review Plans of Care for accuracy, timeliness, and physician signatures
- Ensure proper clinical coding and case-mix accuracy
- Identify documentation gaps and coordinate corrections prior to billing
- Support timely claim submission and reduce billing delays
- Collaborate with clinical, coding, and billing teams to ensure compliance
- Help prevent denials, audit findings, and revenue loss
Qualifications:- Current Registered Nurse (RN) license required
- Home health experience strongly preferred
- Strong knowledge of OASIS, Medicare Conditions of Participation, and home health regulations
- Experience with clinical documentation review, coding, or quality assurance preferred
- Excellent attention to detail, critical thinking, and communication skills
- Knowledge of EPIC preferred.
Posted Salary RangeUSD $90,000.00 - USD $110,000.00 /Yr.
This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, differential pay or other forms of compensation that may be applicable to this job, and it does not include the value of benefits.
