Location
Bridgeport, CT, United States
Posted on
Feb 15, 2021
Profile
Description
Responsibilities
The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses to ensure high accountability of compliance and quality and claims are being reviewed correctly. This position supports and implements programs to establish high quality standards in clinical products and services as well as program and service consistency. Also provides and supports training and process management as needed.
Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Role Essentials
Registered Nurse with active license in state of residence
3 years of clinical experience within Home Health field
Previous experience in medical record reviews/auditing or extensive experience in Home Health
Comprehensive understanding of all related Home Health guidelines including coding, billing and CMS regulations
Able to apply analytical and critical thinking to Home Health record reviews
Working knowledge Microsoft Word, Excel and PowerPoint
High level of emotional intelligence
Ability to work independently and manage work load
At least one of the following certifications:
Home Care Clinical Specialist - OASIS (HCS-O);
Home Care Coding Specialist-Diagnosis (HCS-D);
Certificate for OASIS Specialist-Clinical (COS-C)
Preferred Qualifications
Quality Auditing Experience
Certified Professional Coder (CPC)
Work at Home/Remote Requirements
Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite, wireless and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required
Scheduled Weekly Hours
40
Company info
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