Clinical Review Nurse (Ocean County)
: Job Details :

Responsible for OASIS reviews and comprehensive Home Care assessments. Work directly with team members to educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. Review every Medicare and Managed Medicare admission chart to determine that the coding the clinicians document is appropriate. Perform clinical reviews utilizing the appropriate system. Make coding changes in the system if inappropriate codes are identified. Review each Hospice assessment to assure each CTI, 485 and all diagnoses are consistently matched. Perform chart reviews to determine if the documentation is appropriately/accurately completed per the patients' diagnosis, as well as per state, federal and The Joint Commission guidelines. Perform focused analysis of coding issues to assure that coding accurately reflects the patient's clinical condition. Identify areas of concern through focused coding audits. Report coding issues to the Director of the ce...Clinical, Nurse, Nurse Manager, Clinical Director, County, Healthcare, Patient