Home Health Coder

This role is for one of the Weekday's clients

Min Experience: 5 years

Location: Hyderabad

JobType: full-time

We are seeking an experienced Home Health Coder to join our healthcare documentation and compliance team. The ideal candidate will have in-depth expertise in home health coding and medical coding standards, with a strong understanding of BCHHC (Billing & Coding for Home Health Care) regulations and compliance requirements. This role requires precision, analytical skills, and a solid grasp of home health documentation to ensure accurate coding, optimized reimbursement, and adherence to all applicable healthcare laws and payer guidelines.

Requirements

Key Responsibilities:

• Accurate Coding: Assign appropriate ICD-10-CM diagnosis codes and other relevant codes for home health episodes based on physician documentation, OASIS data, and other supporting clinical records.
• BCHHC Compliance: Apply BCHHC-specific guidelines to ensure compliance with all CMS (Centers for Medicare & Medicaid Services) and payer-specific requirements. Maintain an up-to-date understanding of BCHHC regulations and industry updates.
• Documentation Review: Analyze patient medical records and clinical documentation to verify completeness, accuracy, and alignment with regulatory standards. Collaborate with clinicians to resolve discrepancies or incomplete documentation prior to final coding.
• Quality and Accuracy Audits: Conduct regular audits of coded records to identify errors or trends and implement corrective actions to maintain a high level of coding accuracy and compliance.
• Coding Optimization: Ensure coding practices maximize appropriate reimbursement without compromising compliance. Provide recommendations for documentation improvements to enhance accuracy and claim efficiency.
• Collaboration: Work closely with home health clinicians, billing teams, and compliance officers to ensure seamless information flow and timely claims submission. Provide guidance to staff regarding coding and documentation best practices.
• Training & Development: Stay updated on all coding and regulatory changes affecting the home health industry. Participate in professional development and continuous learning programs to maintain certification and industry knowledge.
• Data Analysis & Reporting: Prepare periodic coding performance reports, track key metrics, and identify areas for process enhancement or risk mitigation related to coding accuracy or claim denials.

Required Skills & Qualifications:

• Experience: 5–12 years of professional experience in home health coding or medical coding within the healthcare or home health industry.
• Technical Expertise: Strong knowledge of ICD-10-CM, CPT, HCPCS, and OASIS data sets specific to home health services.
• BCHHC Knowledge: Demonstrated proficiency in applying BCHHC coding rules and understanding payer requirements for home health reimbursement.
• Attention to Detail: Exceptional accuracy and analytical ability to interpret complex clinical documentation.
• Compliance Knowledge: Familiarity with CMS guidelines, HIPAA regulations, and other healthcare compliance standards.
• Communication Skills: Excellent written and verbal communication to interact with clinical and administrative teams effectively.
• Certifications: Active CIC, CCS, CPC, or HCS-D certification (preferred or required depending on employer policy).