Coding Quality Review Specialist II

At UK St. Claire, our staff is our greatest asset in the mission to create a healthier and more prosperous population. We strive to foster the talent and potential of our employees and prioritize safe working conditions and equal compensation rates to ensure that continual growth is possible. UKSC is a nurturing workplace for all healthcare professionals. We invite you to explore our current job openings and see if our opportunities could be the right fit for you.

Job Description:

Job Summary

Responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes. Ensures appropriate ICD-10 coding and sequencing for accurate reporting. Collaborates with clinical employees to clarify documentation and resolve data integrity issues. Supports quality improvement and compliance with regulatory standards.

Essential Functions

• Assigns ICD-10 CM codes to diagnoses from OASIS, record documentation, and care plans.

• Initiates and follows up with clients to obtain missing or incomplete information for accurate coding.

• Reviews OASIS documentation and ICD-10 coding to ensure accuracy and completeness.

• Consults with clinicians to clarify documentation discrepancies and recommends corrections per agency policy.

• Ensures clinical documentation meets CMS, Joint Commission, federal, and state regulations.

• Collaborates with Audit Specialist to clear charts for prompt and accurate billing.

• Maintains professional and technical knowledge in OASIS and ICD-10 Home Health Coding.

• Provides coding and OASIS education to clinicians onsite and virtually.

• Assists in developing and maintaining competency evaluations for employees on OASIS.

• Performs other duties as assigned.

Education Requirement

Bachelor’s degree in health information management, healthcare administration, or a related field

Master’s degree in health information management, healthcare administration, or a related field is preferred

Experience Requirement

2-3 years of experience in medical coding, quality review, or a relevant area

An equivalent combination of education and experience may be considered.

All experience must be paid and in the same related field.

Part-time and PRN experience will be prorated based on hours worked per week.

Volunteer work and internships for academic credit are not counted.

Certifications & Licensures

N/A

Working Conditions

A. Lifting, pushing, and/or pulling objects up to 50lbs: 2. Occasional (< 10% of the time)

B. Lifting, pushing, and/or pulling objects over 50lbs: 1. Never

C. Standing or walking with objects up to 10lbs: 3. Intermittent (10% - 50% of the time)

D. Standing or walking with objects up to 25lbs: 2. Occasional (< 10% of the time)

E. Sitting at computer workstation for extended periods: 4. Regular (> 50% of the time)

F. Risk of back injury from moving, lifting or positioning patients, equipment, or materials: 1. Never

G. Repetitive motion: 4. Regular (> 50% of the time)

H. Working at heights above 4 feet: 1. Never

I. Working in confined spaces: 1. Never

J. Risk of injuries from use of equipment on the job: 1. Never

K. Job-related travel: 2. Occasional (< 10% of the time)

L. Loud noises: 1. Never

M. Temperature extremes: 1. Never

N. Hazardous chemicals and fumes including waste: 1. Never

O. Radiation: 1. Never

P. Burns: 1. Never

Q. Cuts/Punctures: 1. Never

R. Bloodborne/airborne pathogens: 1. Never

S. Recombinant DNA or viral vectors: 1. Never

T. Combative/violent people: 1. Never

U. Animal handling (including carcasses): 1. Never

V. Please specify other(s) and amount of exposure (i.e. Occasional, Intermittent or Regular): N/A

Physical Demands

This position requires regular sitting at a computer workstation for extended periods of time; performing tasks with repetitive motions (such as typing); intermittent standing or walking with objects weighing up to 10 pounds; and occasional lifting, pushing, and/or pulling of objects up to 50 pounds or standing or walking with objects up to 25 pounds.

Additional Job Descriptions

N/A

Department:

Home Health

Shift:

Day (United States of America)

Time Type:

Full time

Address:

135 N. Hargis Ave.

City, State:

Morehead, Kentucky