Case Manager/ RN

We are now accepting applications for 2 case management positions we have open with a company here in Birmingham, AL. The position is a contract to hire and Monday - Friday. Position. The nurse will be responsible for coding all claims using ICD-Codes including admission, resumption of care, and recertification. Ensure appropriateness of Plans of Care, and validate the thoroughness and accuracy of the OASIS by working closely with clinicians. Ensure quality and prevent over and underutilization. Pay rate $25-30/HR based on experience.

Job Description:

ESSENTIAL JOB FUNCTIONS: · Review OASIS data for quality and develop the correct coding diagnosis to create a clear picture of patient's status at time of admission, resumption of care and recertification.· Reviews discharge OASIS data to ensure appropriate outcomes have been achieved as compared to previous OASIS assessments. · Work closely with the Performance Improvement Coordinator to see that all home health referrals are accurately coded for reimbursement in a timely manner. · Reviews clinical information for appropriateness, congruency and accuracy as it relates to the OASIS and 485, while using the Medicare PPS billing model and CMS guidelines. · Ensure appropriate disciplines and number of visits are requested from physician, based on assessment. · Report feedback to Agency Administrator/Branch Manager regarding their staff's performance and educational needs and/or opportunities for improvement. · Assist with employee orientation as it relates to required documentation and the admission and discharge process as requested. · Provide education and act as a resource to field and office staff with regards to CMS guidelines, Home Care coding, PPS guidelines and billing related issues. · Attend and participate in agency education and staff meetings. · Assists in interpreting federal and state governmental regulations in regard to outcomes. · Review of documentation for compliance with Medicare/Medicaid guidelines; necessity of services and compliance with physician's orders. · Adhere to all of the Company's policies and procedures. · Performs other duties as assigned.

Work Environment:

Very small team that sits in the office. They use an outsource company that works remotely. However, most work is done independently aside from communicating with the clinician and branch manager that they are assigned to. Dress code is business casual.

Qualifications:

• Must hold a current and valid registered nurse license in the state employed. · Advanced understanding of medical terminology and body systems/anatomy, physiology and concepts of disease. · Must have at least two (2) years' experience in home health or hospice agency as an RN. · Must be very detail oriented with understanding of federal and state guidelines for documentation and coding. · Must be able to work cooperatively with other employees. · Must be capable of performing the job functions of this position with or without accommodations.

Performance Expectations:

Complete 12 charts per day (avg 40 min per chart). Each chart needs to get close to the avg reimbursement rate of $25.70. Both must align meaning they cannot complete 12 charts but have a low reimbursement rate or not enough charts with a higher reimbursement rate. Performance is very black and white and will be based on the numbers above. They MUST hit the numbers the productivity reports runs every Monday.

About Aerotek: Aerotek, headquartered in Hanover, Md., is a leading provider of technical, professional and industrial staffing services. Established in 1983, Aerotek is an operating company of Allegis Group, the largest provider of staffing services in the U.S. Aerotek operates a network of more than 200 non-franchised offices throughout the U.S., Canada and Europe. For more information, visit aerotek.com. Aerotek is acting as an Employment Agency in relation to this vacancy.