Oasis Assessment Clinical Reimbursement Coordinator

Job Summary :

The Oasis Assessment Clinical Reimbursement Coordinator plays a critical role in ensuring accurate and compliant documentation of patient assessments to optimize reimbursement outcomes. This position supports the clinical team by reviewing OASIS documentation, coordinating episode planning, and providing education to improve audit results and ensure regulatory compliance.

Key Responsibilities :

Review and validate OASIS assessments for accuracy and completeness to ensure proper HHRG scoring and reimbursement.

Collaborate with clinical managers and field staff to coordinate episode planning and recertifications.

Monitor audit outcomes and identify trends; work with staff to implement corrective actions and training.

Serve as a subject matter expert on OASIS documentation, CMS guidelines, and reimbursement protocols.

Provide ongoing education and support to clinicians on best practices for documentation and assessment.

Communicate with corporate reimbursement teams to align on goals and share insights from field operations.

Stay current with federal and state regulations affecting home health reimbursement and OASIS standards.

Assist in preparing for internal and external audits and surveys.

Report potential financial risks or under-utilization to leadership.

Qualifications :

Registered Nurse (RN) with active license in the state of practice.

Minimum of 2 years of experience in home health, clinical reimbursement, or OASIS assessment.

Strong knowledge of Medicare regulations, HHRG scoring, and OASIS documentation standards.

Excellent communication, analytical, and organizational skills.

Proficiency in EMR systems and clinical documentation software.

Ability to educate and mentor clinical staff effectively.

Preferred Skills :

Certification in OASIS or clinical reimbursement (e.g., COS-C).

Experience with audit preparation and compliance monitoring.

Familiarity with PruittHealth systems and policies.

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As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.