Optimal Care is where your dedication meets a rewarding career.
As a clinician owned and operated company, we create the opportunity and environment for each employee to realize their highest potential while maintaining a personalized focus on our Patients and Families every day. We are the Midwest's premier provider of Physician Services, Home Health, and Hospice Care. Our integrated care delivery model incorporates technology, innovation and best practices. We produce value based outcomes by managing chronic disease process, rehabilitation and end of life care.
We live a simple Mission: Serve Together, Provide Value, and Deliver Exceptional Quality Care.
What does this mean for you? At Optimal Care, you have our resolute commitment to being an exceptional place to work. Your expertise, passion and commitment to exceptional quality care will continue to thrive. With you we can build a remarkable place to work.
Exceptional Benefits:
- Minimum of 3 Weeks Paid Time Off (PTO)
- Company Vehicle Program
- Flexible Work Schedule
- Mentorship Culture
- Medical, Dental, and Vision Insurance
- 401(k) with Employer Match
- Mileage Reimbursement
- Cutting Edge Technology
Key Responsibilities
The Quality Assurance Coder is responsible for accurately coding Home Care and Hospice cases in accordance with current ICD-10-CM coding guidelines. This role ensures that the primary focus of care or terminal diagnosis, along with all relevant comorbidities, are appropriately captured to support high-quality patient care, regulatory compliance, and accurate reimbursement under PDGM.
In this role you will be responsible for:
- Apply ICD-10 diagnosis codes applicable to the patient’s condition, disease processes using ICD-10 coding guidelines and regulations
- Communicates significant findings, problems, & changes related to compliance standards & regulations to the Director of Quality Assurance and QA Specialists
- Review Face to Face documents in home health and hospice for regulatory compliance
- Uses the Face-to-Face documentation to identify the focus of care for home health and the continuing criteria for eligibility for hospice patients
- Assists with tracking to ensure timely billing and meets regulatory guidelines
- Prepares reports as directed by Director of Quality Assurance
- Maintains knowledge of changes in COP’s which affect quality improvement activities and patient care
- Audits medical records using critical thinking skills
- Manages workflow, identifies problematic sequencing, and provides solutions to avoid impact on patient care activities
- Assures all federal, state and local regulations and OSHA regulations standards of practice are adhered to
- Maintains knowledge of current Medicare, Medicaid and third-party regulations and changes and ensures compliance
- Maintains current knowledge of and promotes compliance with all federal, state and local regulations
- Demonstrates knowledge of current status of requirements of third-party payor, by identifying and reporting potential payment coverage problems
- Assists with special audits as requested or assigned by Director of Quality Assurance
Required Qualifications
- High School Diploma or GED
- Current ICD-10 Coding Certification
- Minimum 3 years of quality assurance experience
- Demonstrated interpersonal skills with ability to communicate effectively
- Demonstrated decision making and financial management skills
- Exhibits working knowledge of regulations and reimbursement in home health and hospice
- Willing to develop new critical thinking skills
Desired Qualifications
- Microsoft office skills preferred
Location
- This is a remote opportunity for individuals living in Michigan, Ohio, Indiana, Mississippi, or Texas only
Hours
- 8:00 am – 5:00 pm, Monday through Friday
Background Screening
Optimal Care conducts a background screening upon acceptance of a contingent job offer. Background screening is completed by a third-party administrator, the Michigan Long-Term Care Partnership, and is performed in compliance with the Fair Credit Report Act.
Reasonable Accommodations
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Equal Opportunity Employer
Optimal Care is an equal-opportunity employer.
