OASIS QA Reviewer

📋 Description

• • Lead training and orientation for new QA reviewers, delivering skill-based instruction on OASIS coding standards and clinical quality protocols.
• • Conduct quality assurance audits of clinical reviews, documenting findings and reporting deviations to QA leadership with actionable insights.
• • Serve as the primary expert resource for reviewers and clients, providing clear, accurate guidance on OASIS, ICD-10 coding, and clinical documentation requirements.
• • Ensure knowledge management resources are consistently updated, accessible, and leveraged by all reviewers to maintain compliance and accuracy.
• • Test and validate functionality of McBee Clinical Review software to identify system issues affecting coding accuracy and quality outcomes.
• • Resolve complex client and reviewer inquiries related to clinical documentation, coding compliance, and regulatory standards in a timely and authoritative manner.
• • Identify systemic quality concerns and escalate them to QA leadership with evidence-based recommendations for process improvement.
• • Maintain strict adherence to OASIS and ICD-10 coding guidelines across all audit and training activities to support clinical outcome integrity.
• • Collaborate cross-functionally to align QA review processes with Netsmart’s broader mission of improving care delivery in behavioral health, human services, and post-acute markets.
• • Support continuous improvement of reviewer performance through feedback, mentoring, and targeted educational interventions based on audit results.
• • Ensure all quality assurance documentation meets regulatory and internal standards for completeness, accuracy, and traceability.
• • Act as a liaison between clinical reviewers, clients, and internal technology teams to bridge gaps between coding standards and software functionality.
• • Promote a culture of clinical excellence by reinforcing the importance of precise documentation in advancing patient care and outcomes.
• • Remain current on evolving OASIS guidelines, CMS requirements, and industry best practices to ensure organizational compliance and operational excellence.