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Registered Nurse (RN) - Coding & Utilization (Home Health) - Full-Time Day

Prisma Health
United States, South Carolina, Columbia
Nov 09, 2024
Inspire health. Serve with compassion. Be the difference. Job Summary This position provides coding and utilization analysis for Homecare patients and clinical staff. This job requires analytical skills and close attention to detail. All team members are expected to be knowledgeable and compliant with Prisma Health's values of compassion, dignity, excellence, integrity and teamwork. Accountabilities Provide coding and coding education to clinical and administrative staff of Home Health and Hospice. Recognize when projected visits may result in over utilization of service and exceeds PPS reimbursement. Work in collaboration with QA OASIS-C reviewers to ensure month-end closing deadlines are met for coding and documentation review. Provide analysis and review of coding and compliance matters, to include research and interpretation of government regulations and payor billing requirements. Keep department manager up to date on regulations and events that impact Homecare coding and utilization. Maintain current working knowledge of PPS guidelines. Assist with development of coding and billing procedures for new services. Compile clinical staff utilization data and provide comprehensive and/or statistical reports to management as requested. Accept assignments outside normal duties when such fulfills an agency need. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Education Graduate of an accredited school of Nursing program and approved by the South Carolina State Board of Nursing required. Bachelor's degree in Nursing preferred. Minimum Experience At least 2 years' experience in home health. Must have experience working with ICD9 & training in ICD10 preferred. Experience using utilization software such as PPS Plus is preferred. Required Certifications/Registrations/Licenses Current South Carolina nursing license, current ICD9 certification, and ICD10 certification when enacted. Other Required Experience Must be computer literate. Must have experience with Microsoft applications (i.e. Word, Excel). Work Shift Day (United States of America) Location Baptist Facility 1521 Home Health - Midlands Department 15219035 Administrative and General Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.