ICD-10 Coding Specialist, Home Health & Hospice

Job Description:

• Review home health and hospice clinical documentation across SOC, ROC, Recertification, Transfer, Discharge, and Admission time points
• Assign accurate ICD-10-CM diagnosis codes
• Sequence diagnoses according to ICD-10-CM guidelines, CMS requirements, PDGM payment methodologies, and hospice coding expectations
• Audit clinical charts for documentation gaps or inconsistencies
• Collaborate with clinical leadership and compliance teams to resolve query needs
• Meet productivity and turnaround-time goals to support billing and claim submissions
• Assist with internal quality assurance and external medical reviews, including TPE, ADRs, and compliance audits
• Collaborate with clinical, QA, compliance, and revenue cycle teams to improve documentation integrity and regulatory readiness
• Maintain current knowledge of CMS guidance, Medicare regulations, LCDs, and payer-specific updates
• Protect PHI and ensure HIPAA compliance
• Generate and maintain tracking logs, status updates, and coding reports for management

Requirements:

• 2+ years in Home Health, ICD-10 coding, and OASIS review
• Active HCS-D and HCS-O certifications
• Extensive background in Plan of Care (POC) and HOPE documentation review
• Comprehensive mastery of PDGM, Medicare CoPs, HHVBP, Star Ratings, and ICD-10 Official Coding Guidelines
• Strong knowledge of home health and hospice coding guidelines, Medicare Conditions of Participation, LCD/NCD guidance, PDGM requirements, hospice eligibility documentation, and diagnosis sequencing
• Preferred CHS-C certification
• Dual-specialty coding experience across Home Health and Hospice care settings
• Direct experience supporting TPE, ADR, medical reviews, and internal/external compliance audits
• Proficiency in industry-standard EMRs, such as Homecare Homebase, WellSky, MatrixCare, Careficient, and Netsmart
• Solid understanding of OASIS accuracy, clinical quality measures, hospice documentation integrity, and billing-related coding guidelines
• Exceptional verbal and written communication skills
• Ability to work autonomously, manage priorities, meet tight turnaround times, and work with minimal supervision
• Strong clinical judgment and meticulous attention to detail
• Proficiency in proactive problem identification, timely escalation, confidentiality, and HIPAA compliance
• Ability to secure and maintain own equipment, secure internet access, and relevant certifications
• Must be located within the United States

Benefits:

• No set hours; flexible schedule subject to established review-assignment due dates
• 1099 contractor arrangement
• Opportunity to support mission-driven home health, hospice, and home care organizations
• Compensation per chart, including higher rates for Coding and OASIS/HOPE or Coding/OASIS/HOPE/POC work