Overview
Medical Review Nurse Coder (Home Health)
Job Summary: The Catholic Health Home Care Medical Review Nurse Coder is responsible for ensuring the accuracy, completeness, and regulatory compliance of home health clinical documentation prior to billing. This role reviews OASIS assessments, patient charts, Face-to-Face (F2F) encounters, physician orders, and Plans of Care to support Medicare Conditions of Participation, payer requirements, and timely reimbursement.
Role Impact: This role is essential to maintaining regulatory compliance, ensuring accurate reimbursement, and supporting high-quality, timely patient care in the home health setting.
Job Details
Key Responsibilities
Review OASIS assessments for accuracy, completeness, and compliance
Audit patient records to ensure documentation supports billed services
Validate Face-to-Face (F2F) encounters for regulatory compliance
Review Plans of Care for accuracy, timeliness, and physician signatures
Ensure proper clinical coding and case-mix accuracy
Identify documentation gaps and coordinate corrections prior to billing
Support timely claim submission and reduce billing delays
Collaborate with clinical, coding, and billing teams to ensure compliance
Help prevent denials, audit findings, and revenue loss
Qualifications
Current Registered Nurse (RN) license required
Home health experience strongly preferred
Strong knowledge of OASIS, Medicare Conditions of Participation, and home health regulations
Experience with clinical documentation review, coding, or quality assurance preferred
Excellent attention to detail, critical thinking, and communication skills
Knowledge of EPIC preferred.
Salary Range
USD $90,000.00 - USD $110,000.00 /Yr.
This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, differential pay or other forms of compensation that may be applicable to this job, and it does not include the value of benefits.
At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.
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