Oasis Reviewer

POSITION SUMMARY: The OASIS Reviewer is responsible for analyzing the data integrity and consistency of OASIS documentation and assessment processes. Working under the direct supervision of the Coding and OASIS Manager of Synergy Shared Services (SSS) and collaborating with agencies within the scope of work, this role will be vital in ensuring the accuracy and reliability of the OASIS documentation process.  

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: 

• Prospectively review all OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and agency policy. 
• Utilize OASIS variation or alert reports when reviewing OASIS data. 
• Consult with appropriate clinical staff to clarify any data integrity issues and work with clinician to make appropriate corrections per agency policy. 
• Review visit utilization for appropriateness of care guidelines and patient condition; report potential financial losses and/or underutilization to the Coding and OASIS Manager, Clinical Manager and/or designee. 
• Notify Coding and OASIS Manager, Clinical Manager and/or designee of problematic trends as a result of OASIS review. 
• Participate in Quality Improvement and Corporate Compliance activities as assigned. 
• Assist with other chart audit activities as assigned. 
• Maintain professional and technical knowledge by attending educational workshops and reviewing professional publications. 
• Understand and demonstrate CAPLICO values. 
• Other duties and special projects as assigned. 

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description. 

QUALIFICATIONS & REQUIREMENTS FOR THE POSITION: 

• Working knowledge of OASIS process. 
• Understanding of federal regulations and state licensure requirements for home health. 
• Must be self-motivated and able to work independently while being collaborative and able to work as part of an interdisciplinary team. 
• Outstanding written and verbal communication skills.  
• Must have strong computer skills to utilize Microsoft Outlook and agency systems. 
• Understanding of the legal and regulatory framework governing the home health industry. 
• Current Driver’s License, vehicle insurance, and access to a dependable vehicle or public transportation. 

PREFERRED KNOWLEDGE AND SKILLS:   

• At least two (2) years of home health clinical, coding, or billing experience. 
• OASIS certification (COS-C).