Audit Home Health medical records to validate or revise billed services based on CMS guidelines
Apply clinical judgment and coding expertise to identify overpayments and ensure proper reimbursement
Document audit findings with clarity, professionalism, and precision using OASIS, ICD-10 CM, and CMS Home Health guidelines
Utilize industry-leading tools like Decision Health, Webstrat, and proprietary EXL platforms to complete your work efficiently
Identify audit trends and help drive improvements that benefit both providers and patients
Stay current on the latest clinical and reimbursement guidelines and deliver work that meets or exceeds productivity and quality benchmarks

LPN or Registered Nurse (Associate’s or Bachelor’s degree preferred)
3+ years of home health nursing experience, with strong consideration for candidates holding OASIS or Coding certifications
Deep knowledge of PDGM and PPS payment methodologies
Proficiency in auditing and coding tools (Decision Health, ICD-10, Webstrat)
Strong command of Microsoft Office, including Excel, Word, and OneNote
Exceptional time management, attention to detail, and independent work ethic
Clear and confident communicator – both in writing and verbally
Passion for improving healthcare through teamwork, collaboration, and continuous learning.

Home Health Auditor III

Key skills