The Quality Auditor – Home Health Coding is responsible for performing audits of home health documentation to ensure coding accuracy, OASIS alignment, and regulatory compliance. This role plays a key part in optimizing reimbursement, reducing compliance risks, and enhancing overall documentation quality. The ideal candidate has in-depth knowledge of ICD-10-CM coding guidelines, OASIS conventions, and Medicare regulations governing home health services.

• Conduct retrospective and concurrent coding audits of patient records, including OASIS assessments, Plan of Care, and clinical documentation.
• Evaluate accuracy of diagnosis coding and adherence to ICD-10-CM guidelines specific to home health care.
• Validate alignment between OASIS responses and clinical documentation.
• Identify documentation inconsistencies and provide recommendations for improvement.
• Collaborate with clinical staff and coders to ensure accurate coding and documentation practices.
• Provide feedback, training, and educational support to clinicians and coders based on audit findings.
• Track, trend, and report audit results to management; assist in developing action plans for continuous improvement.
• Monitor compliance with CMS, Medicare, and accrediting body requirements related to coding and clinical documentation.
• Stay current with regulatory changes, coding updates, and industry best practices.

• Quality Experience: Minimum 1 year
• Home Health Coding Experience: Must be Minimum of 1 year
• Total requirement: 10 (5-Day shift, 5- Night shift)
• Strong communication and comprehension skills.
• Proficiency in analysing quality metrics and making data-driven decisions.
• In-depth knowledge of HHC specific regulations and compliance requirements.
• Familiarity with electronic health record (EHR) systems and quality management tools.
• Hands on experience in OASIS

Preferred Qualifications

Education & Certification:

• High School diploma or equivalent required; Associate or Bachelor’s degree in health-related field preferred.
• Certified Home Health Coder (e.g., HCS-D, HCS-O, or BCHH-C) preferred.
• ICD-10-CM coding certification required.

Experience:

• Minimum of 3 years of experience in home health coding and OASIS review.
• Prior experience conducting coding or clinical documentation audits strongly preferred.
• Strong understanding of Medicare home health PPS and OASIS-E.

Skills:

• Proficient in coding software and EMR systems (e.g., Homecare Homebase, WellSky).
• Strong analytical, critical thinking, and attention to detail.
• Excellent communication and education skills.
• Ability to work independently and manage multiple priorities.