Home Health Coder
1 week ago
This role is for one of the Weekday's clientsMin Experience: 5 years
Location: Hyderabad
JobType: full-time
We are seeking an experienced Home Health Coder to join our healthcare documentation and compliance team. The ideal candidate will have in-depth expertise in home health coding and medical coding standards, with a strong understanding of BCHHC (Billing & Coding for Home Health Care) regulations and compliance requirements. This role requires precision, analytical skills, and a solid grasp of home health documentation to ensure accurate coding, optimized reimbursement, and adherence to all applicable healthcare laws and payer guidelines.
RequirementsKey Responsibilities:
- Accurate Coding:
Assign appropriate ICD-10-CM diagnosis codes and other relevant codes for home health episodes based on physician documentation, OASIS data, and other supporting clinical records. - BCHHC Compliance:
Apply BCHHC-specific guidelines to ensure compliance with all CMS (Centers for Medicare & Medicaid Services) and payer-specific requirements. Maintain an up-to-date understanding of BCHHC regulations and industry updates. - Documentation Review:
Analyze patient medical records and clinical documentation to verify completeness, accuracy, and alignment with regulatory standards. Collaborate with clinicians to resolve discrepancies or incomplete documentation prior to final coding. - Quality and Accuracy Audits:
Conduct regular audits of coded records to identify errors or trends and implement corrective actions to maintain a high level of coding accuracy and compliance. - Coding Optimization:
Ensure coding practices maximize appropriate reimbursement without compromising compliance. Provide recommendations for documentation improvements to enhance accuracy and claim efficiency. - Collaboration:
Work closely with home health clinicians, billing teams, and compliance officers to ensure seamless information flow and timely claims submission. Provide guidance to staff regarding coding and documentation best practices. - Training & Development:
Stay updated on all coding and regulatory changes affecting the home health industry. Participate in professional development and continuous learning programs to maintain certification and industry knowledge. - Data Analysis & Reporting:
Prepare periodic coding performance reports, track key metrics, and identify areas for process enhancement or risk mitigation related to coding accuracy or claim denials.
- Experience: 5–12 years of professional experience in home health coding or medical coding within the healthcare or home health industry.
- Technical Expertise: Strong knowledge of ICD-10-CM, CPT, HCPCS, and OASIS data sets specific to home health services.
- BCHHC Knowledge: Demonstrated proficiency in applying BCHHC coding rules and understanding payer requirements for home health reimbursement.
- Attention to Detail: Exceptional accuracy and analytical ability to interpret complex clinical documentation.
- Compliance Knowledge: Familiarity with CMS guidelines, HIPAA regulations, and other healthcare compliance standards.
- Communication Skills: Excellent written and verbal communication to interact with clinical and administrative teams effectively.
- Certifications: Active CIC, CCS, CPC, or HCS-D certification (preferred or required depending on employer policy).
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