Job: Clinical Data Coordinator

Nightingale Homecare emphasizes teamwork, nurturing and encouragement. We believe that by supporting each individual's talents, we all succeed, most especially our clients. Our special working environment explains why we attract and retain professionals who aspire to make our work and our world a better place. If you are yearning for a healthcare experience where you are valued and appreciated, you owe it to yourself to experience . . . the Nightingale difference.

The Clinical Data Coordinator is responsible for the review, oversight and monitoring of all clinical data submitted from field employees prior to submission to the billed entity. The Clinical Data Coordinator works closely with the RN Clinical Managers to ensure current clinical documentation standards are met and maintained as mandated by State and Federal guidelines and Nightingale Homecare’s Policy and Procedure guidelines. This position works closely with and reports to the Clinical Quality and Compliance Manager and the RN Clinical Managers.


ESSENTIAL JOB FUNCTIONS

• Maintains current knowledge of state and federal clinical documentation standards and consistently applies this knowledge to the documentation review process
• Assists RN Clinical Managers and clinical staff members as needed to assure that there is an appropriate plan of care in place
• Conducts clinical proofing of OASIS documentation (SOC, recertification and discharge), plans of care and diagnosis coding to assure compliance and maximize the agency’s position with respect to reimbursement and clinical outcomes
• Reviews clinical documentation to ensure that OASIS answers are supported in documentation and that compliance standards are met with respect to orders and interim orders for visiting frequencies, interventions, parameters, medications, etc.
• Reviews the entire 485 for completeness and accuracy prior to submission to the physician.
• Collaborates and acts as a resource to Clinical Managers and other departments in quality and regulatory matters
• Participates in case conferences and clinical team meetings to provide guidance and feedback on quality, compliance and documentation issues
• Keeps RN Clinical Managers informed of documentation issues relating to specific field staff employees who are completing documentation that doesn’t meet home care nursing practice standards.
• Manages and reviews “to-do” lists in the electronic medical record system, including OASIS rejected, OASIS to review, OASIS to complete, 485/interim to review, and auto-sign OASIS.
• Participates in medical record audits to evaluate compliance with Medicare conditions of participation, utilization patterns, quality of care and agency-wide performance improvement initiatives
• Processes requests for 488s, additional documentation and denials in a timely fashion
• Maintains confidentiality of patient information as well as Nightingale Homecare matters.
• Participates in an ongoing Quality Assurance program

Knowledgeable of the statutory and administrative rules of State and Federal Home Care
guidelines to ensure compliance within the Agency.

Excellent clinical judgment and critical thinking skills.

Computer Proficiency. Familiarity with Healthcare Documentation Software.

Ability to learn, assimilate and apply principles of current health care practice.

Ability to organize work procedures, assume responsibility and effectively supervise others.

Possesses excellent problem solving techniques and abilities.

Be knowledgeable of the statutory and administrative rules of State and Federal Home Care
guidelines to ensure compliance within the Agency.

Mental acuity to adequately perform job requirements.

Excellent organizational skills. Excellent oral and written communication skills. Excellent problem solving skills. Excellent time management skills.

Must possess a current Arizona license as a Registered Nurse, active and in good standing.

RN Graduate of an approved school of nursing, or higher degree.

Minimum 3 years experience as a field homecare nurse preferred.

Familiarity with Healthwyse system preferred.