ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
- Clinical Record Reviews CRR including a focus on: verification of documentation, quality of care provided, visit utilization, adherence to the plan of care/agency policies & procedures, evidence of communication between all disciplines, etc. to ensure proper documentation to maximize reimbursement.
- Maintain agency CRR compliance at 80% or greater.
- Communication with the Clinical Manager/Administrator of trends as presented through QA data, situations requiring process changes or staff training/action based upon QA data.
- Participation in Agency orientation & in-service training programs.
- Other duties as assigned
QUALIFICATIONS AND EXPERIENCE:
- A Registered Nurse preferred with a current state license.
- A minimum of 2 years of home health experience, 1 of which shall include experience in QA of a home health agency.
- Must have a working knowledge of state regulations/requirements, good organizational, interpersonal and judgement skills.
- Must be able to develop action plans and resolve identified inconsistencies.
- Knowledge of homecare regulations, CMS guidelines, accreditation standards, and documentation requirements.
- Experience with chart audits, quality improvement processes, and compliance review preferred.
- Familiarity with OASIS, electronic medical records EMR, and home health billing documentation is highly desirable.
- Strong analytical, organizational, and problem-solving skills.
- Excellent written and verbal communication skills.
- Ability to work independently and collaboratively with interdisciplinary teams.
- Able to hear, speak, understand and communicate effectively in English.
