[Hiring] Part Time OASIS CMS 485 Review Specialist Medical Billing and Coding @Qualicare, Frisco
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
We need a certified OASIS and CMS 485 ninja who lives for clean claims and audit-proof documentation. You’ll start part-time reviewing OASIS assessments, finalizing CMS 485 Plans of Care, and coding/billing Medicare episodes—all from home. As census grows, this role scales to full-time with leadership opportunities.
Day-to-Day (Part-Time Phase):
- Conduct thorough OASIS start-of-care, resumptions, recerts, and discharges (accuracy ≥ 98%)
- Review/revise CMS 485 Plans of Care for compliance and reimbursement optimization
- Assign ICD-10, CPT, and HCPCS codes; scrub claims in [your EMR/billing system]
- Flag and correct RAP/NOA errors before submission
- Provide concise clinician education via email/Zoom (no field visits)
- Prep for ADR, ZPIC, and TPE audits
Full-Time Path (3–6 months):
- Lead OASIS QA program
- Train new clinicians/coders
- Manage full billing cycle
Qualifications
- Active credential: COS-C or HCS-O (OASIS specialist)
- CPC, CPC-H, or CCS-P (AAPC/AHIMA coding certification)
- 3+ years home health OASIS review + CMS 485 finalization
- Proven Medicare billing/coding experience (RAPs, NOAs, final claims)
- EMR proficiency (Kinnser/WellSky)
- U.S. work authorization & high-speed internet
Requirements
- Experience with PDGM case-mix optimization
- Prior remote auditing or consulting
Benefits
- Competitive salary
- Flexible schedule
- Opportunity for advancement
This is a remote position.