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TYPE OF WORK
Full Time
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SALARY
5/hour
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HOURS PER WEEK
40
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DATE UPDATED
Aug 12, 2026
Position Summary:
Nurse Next Door is seeking a detail-oriented Registered Nurse – Clinical Billing & Coding Specialist to support the administrative and financial operations of our growing home health agency. This position focuses on ensuring accurate clinical documentation, OASIS review, coding, billing compliance, and coordination with the clinical team to maximize reimbursement while maintaining the highest standards of patient care and regulatory compliance.
The ideal candidate has a strong understanding of home health billing, ICD-10 coding, OASIS documentation, Medicare regulations, and reimbursement guidelines.
Essential Duties & Responsibilities:
-Review and audit clinical documentation for completeness, accuracy, and compliance.
-Review and validate OASIS assessments for accuracy and reimbursement optimization.
-Assign and validate appropriate ICD-10 diagnosis codes in accordance with Medicare guidelines.
-Prepare, review, and submit home health billing accurately and timely.
-Ensure compliance with Medicare, Medicaid, commercial insurance, and state/federal billing regulations.
-Identify documentation deficiencies and collaborate with clinicians to obtain necessary corrections.
-Monitor claim submissions, denials, and payment trends while assisting with appeals and claim resolution.
-Maintain current knowledge of CMS regulations, OASIS guidance, reimbursement methodologies, and coding updates.
-Participate in internal audits and prepare reports related to billing accuracy and compliance.
-Maintain confidentiality and compliance with HIPAA regulations.
-Perform other administrative and clinical support duties as assigned.
Qualifications:
Required:
-Active Registered Nurse (RN) license.
-Degree or certification in Medical Billing & Coding.
-Experience with OASIS documentation and review.
-Strong knowledge of ICD-10 coding principles.
-Experience working in home health or hospice.
-Excellent organizational skills and attention to detail.
-Strong written and verbal communication skills.
-Proficiency with Microsoft Office and electronic medical record systems.
Preferred:
-Certified OASIS Specialist (COS-C) or equivalent certification.
-Home health coding certification (HCS-D or similar).
-Experience with Medicare home health reimbursement and PDGM.
-Previous Quality Assurance or Clinical Documentation Review experience.
Knowledge & Skills:
-Home Health Medicare Conditions of Participation
-OASIS-E documentation and review
-ICD-10-CM coding
-PDGM reimbursement
-Medicare and Medicaid billing
-Claims management and denial resolution
-Regulatory compliance
-Clinical documentation improvement
-Strong analytical and problem-solving skills
-Ability to work independently while collaborating with interdisciplinary teams
Monday-Friday United States PST time zone; possible weekends
