Job Description
Oasis Reviewer
Pennant
• Prospectively review all OASIS assessments to ensure appropriateness, completeness, and regulatory compliance. • Evaluate OASIS data for internal consistency, accuracy, and alignment with patient condition and care delivery. • Utilize OASIS variation, validation, or alert reports to identify potential data integrity concerns. • Ensure documentation supports accurate clinical representation and compliant reimbursement. • Partner with clinicians and agency staff to clarify documentation discrepancies or data integrity issues. • Provide guidance to clinicians on appropriate corrections in accordance with agency policy and regulatory standards. • Support education and reinforcement of best practices related to OASIS completion and assessment accuracy. • Review visit utilization for alignment with patient condition, plan of care, and clinical guidelines. • Identify and report potential underutilization, overutilization, or financial risk to the Coding and OASIS Manager, Clinical Manager, or designee. • Escalate trends that may impact reimbursement, outcomes, or compliance. • Identify and communicate problematic trends or recurring issues identified through OASIS review. • Participate in Quality Improvement and Corporate Compliance initiatives as assigned. • Assist with additional chart audits or documentation reviews as needed. • Maintain current knowledge of OASIS standards, regulatory changes, and industry best practices. • Demonstrate and uphold CAPLICO values in all interactions and work practices.
Job Requirements
- Working knowledge of the OASIS data set and assessment process.
- Strong understanding of federal regulations and state licensure requirements for home health.
- Knowledge of the legal and regulatory framework governing the home health industry.
- Ability to work independently while maintaining strong collaboration with interdisciplinary teams.
- Excellent written and verbal communication skills.
- Strong computer proficiency, including Microsoft Outlook and agency documentation systems.
- Valid driver’s license, vehicle insurance, and access to reliable transportation or public transportation.
- At least two (2) years of home health clinical, coding, or billing experience (preferred).
- OASIS certification (COS-C) (preferred).
Benefits
- Professional development
- Ongoing education through workshops and training
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