Clinical Reviewer - Ohio Living

You’re our clinical check and balance!

You’re an “I” dotter and a “T” crosser, and detail-oriented, collaborative, and organized are all words that describe your work style. Behind the scenes is where you’re most comfortable and you enjoy supporting the clinical team. OASIS-C, 485s, and ICD-10 coding are all your expertise and your knowledge and experience make you the perfect Clinical Reviewer at Ohio Living.

Why Ohio Living is different

• Build relationships. You’ll love the connection you build with local clinical teams and the way that the work you do allows us to best care for our patients.
• Be a leader. Even though you will spend most of your time in the office, you will lead your team from a distance!
• Support and rewards. You can expect the technology you need to access the information required to get the job done.
• Attractive pay and benefits. We offer everything you expect, plus a retirement plan, paid time off, education assistance, pay advances up to $500, and recognition programs.

What you’ll do

The Clinical Reviewer reviews and approves of all patient information that is provided by the licensed professional during a start of care, recertification, resumption of care, or evaluation visit while promoting quality patient care, ensuring stable relationships with referral sources, patients, caregivers, and staff members, and assists with the training agency staff in accordance with company standards and federal, state, and local standards, guidelines, and regulations.

What it takes

Qualifications & Education

• High school diploma or equivalent required.
• Two (2) years of post-secondary education in a clinical specialist or medical records program or Certificate for OASIS Specialist-Clinical (COS-C) designation from the OASIS Certificate and Competency Board

(OCCB) required.

• Current unencumbered license for the state of Ohio to practice as a Licenses Practical Nurse (LPN) is preferred.

• Certification in ICD-10 diagnosis coding required or willing to obtain within six (6) months of hire.

Experience

• Two years of medical-surgical, medical records management, or healthcare billing experience required.
• Experience with ICD-10 medical coding required.
• Experience in a Medicare-certified home health agency preferred.
• Proficiency with Windows, Microsoft Office (Word, Excel, PowerPoint), and the internet required.

Other Requirements

• Must be able to read, write, speak, and understand the English language.

Clinical Practice and Documentation

• Responsible to process Home Health Starts of Care (SOC) or Hospice Admission Plans of Care timely working with their assigned Home Health and Hospice office.
• Maintains accepted productivity of all Plans of Care. Assists other Clinical Reviewers as needed to ensure Ohio Living Home Health and Hospice as a whole keeps within accepted benchmarks for Plan of Care completion and provider approval.
• Completes review of evaluation packets, OASIS-C, 485s and other clinical information for home health and hospice ensuring consistency with the comprehensive assessment of the 485.
• Reviews both the data submitted from the field staff to ensure accuracy and follows up on any documentation that requires correction.
• Completes ICD-10 coding based on clinical documentation in accordance with company standards and federal, state, and local standards, guidelines, and regulations.
• Ensures that service utilization correlates with the assessment data.
• Processes the OASIS and verifies the correct start of care date and episode date range.
• Processes any unlisted supplies, medications, activity, functional limitations, allergies, etc. that appear on the action screen to ensure completion of the 485.
• Ensures that appropriate care types and Plan of Care (POC) are selected based on the patient’s medical condition and the staff’s assessment data.
• Reviews Resumption of Care (ROC) and Discharge Assessment Data to ensure accuracy and follows up on any documentation that requires correction.
• Processes the ROC and discharge OASIS.
• Ensures that the patient’s POC is completed and reassessed by the appropriate health care professional when there is a significant health status change in the patient’s condition at the physician’s request and after hospital discharge.
• Ensures appropriate documentation is completed for all patients transferred to an inpatient facility.
• Assists the clinical management staff with conducting OASIS and documentation portions of the job-specific orientation as requested.
• Assists with identification of and then provides additional training for employees on OASIS documentation. Keeps clinical management staff apprised of any additional training needs for staff members.
• Serves as a clinical resource to the Home Health Clinical Supervisors as well as the clinical teams for coding and clinical documentation.
• Evaluates and processes add-on visits to SOC and ROC.
• Processes hospice SOC and the Hospice Item Set to prepare required information for billing.
• Participates in orientation of newly hired Clinical Reviewers as requested.

Ohio Living is among the country's leading comprehensive resources on aging well. Ohio Living Home Health & Hospice, a wholly owned subsidiary of Ohio Living, is one of Ohio’s premier providers of home health and hospice support for adults, wherever they live. Most importantly, we’re a company that:

• chooses to operate as a faith-based, not-for-profit organization
• makes its mission the heart of our organization by consistently exceeding the needs and expectations of those we serve
• provides an engaging, recognition centered, team-oriented workplace dedicated to career, family and faith

Why work at Ohio Living?

Depending on an employee’s status, they may benefit from:

• competitive wages
• medical, dental, and vision insurance
• 403b retirement savings
• paid time off including your birthday
• training, continuing education, and education assistance
• pay advances up to $500
• the latest technology
• unlimited career opportunities
• and much more!

Who is Ohio Living?

Headquartered in Columbus, Ohio Living is one of the nation’s largest not-for-profit, multi-site senior living organizations. Since its founding in 1922, Ohio Living has defined the highest standards of quality of life for adults in 50 Ohio counties.

Our mission is to provide adults with caring and quality services toward the enhancement of physical, mental and spiritual well-being consistent with the Christian Gospel.

Our Values:
Care  •  Integrity  •  Customer Service  • Innovation

Financial Stewardship  •  Leadership  •  Inclusion