Clinical Integrity Auditor
• Reviewed clinical documentation at start of care, resumption of care, and recertification to ensureadequate Diagnosis & Oasis coding.• Participated & organized continued education with agency staff aimed to improve clinicaldocumentation to ensure accuracy and compliance with coding.• Promoted compliance with different pay sources, especially with Medicare and Medicaid, to certify eligibility, and face-to face requirements were met.• Review of referral & clinical documentation to support face-to-face documentation, or if needed collaboration between clinician and plan of care coordinator to make sure appropriate information were included in the 485 statements for physician to attest to for the certification period.• Superior attention to detail, able to work independently, self-driven and a dedicated employee; also works well within a group.• Transitioned into new EMR. Described as a super user to clinicians during the transition.Asked to transfer to new department, Clinical Revenue Integrity, to validate OASIS items, review ICD-10codes and improve HHRG and HH star ratings for the agency.• Proficient in Microsoft excel, and multiple EMRs. • Initiated tracking board of barriers causing a delay in payment, release of care plan, and/or review atstart of care, resumption, or recertification in preparation of PDGM.• Certified Oasis coder, on first attempt, within year of implementation of new Revenue Integritydepartment for agency.
