Oasis Reviewer

OASIS Reviewer Join Synergy’s dynamic clinical quality and data integrity team as an OASIS Reviewer supporting Home Health agencies. We are seeking a detail oriented, analytically strong professional with deep knowledge of OASIS requirements to ensure the accuracy, consistency, and regulatory compliance of OASIS documentation. This role plays a critical part in safeguarding data integrity, supporting appropriate reimbursement, and strengthening quality outcomes across the organization.

About the Role The OASIS Reviewer is responsible for the prospective review of OASIS assessments to ensure accuracy, completeness, and compliance with federal and state regulations, as well as agency policy. Working under the direction of the Coding and OASIS Manager and in close collaboration with agency clinical teams, this role serves as a key quality checkpoint in the home health documentation process.

The position requires strong regulatory knowledge, clinical insight, and the ability to collaborate effectively with clinicians to resolve data integrity issues.

Key Responsibilities OASIS Review & Data Integrity
• Prospectively review all OASIS assessments to ensure appropriateness, completeness, and regulatory compliance.
• Evaluate OASIS data for internal consistency, accuracy, and alignment with patient condition and care delivery.
• Utilize OASIS variation, validation, or alert reports to identify potential data integrity concerns.
• Ensure documentation supports accurate clinical representation and compliant reimbursement.

Clinical Collaboration & Issue Resolution
• Partner with clinicians and agency staff to clarify documentation discrepancies or data integrity issues.
• Provide guidance to clinicians on appropriate corrections in accordance with agency policy and regulatory standards.
• Support education and reinforcement of best practices related to OASIS completion and assessment accuracy.

Utilization & Financial Impact Review
• Review visit utilization for alignment with patient condition, plan of care, and clinical guidelines.
• Identify and report potential under utilization, over utilization, or financial risk to the Coding and OASIS Manager, Clinical Manager, or designee.
• Escalate trends that may impact reimbursement, outcomes, or compliance.

Quality Improvement & Compliance Support
• Identify and communicate problematic trends or recurring issues identified through OASIS review.
• Participate in Quality Improvement and Corporate Compliance initiatives as assigned.
• Assist with additional chart audits or documentation reviews as needed.

Professional Development & Organizational Values
• Maintain current knowledge of OASIS standards, regulatory changes, and industry best practices.
• Participate in ongoing education through workshops, training, and professional publications.
• Demonstrate and uphold CAPLICO values in all interactions and work practices.
• Perform other duties and special projects as assigned.

Qualifications Required
• Working knowledge of the OASIS data set and assessment process.
• Strong understanding of federal regulations and state licensure requirements for home health.
• Knowledge of the legal and regulatory framework governing the home health industry.
• Ability to work independently while maintaining strong collaboration with interdisciplinary teams.
• Excellent written and verbal communication skills.
• Strong computer proficiency, including Microsoft Outlook and agency documentation systems.
• Valid driver’s license, vehicle insurance, and access to reliable transportation or public transportation.

Preferred
• At least two (2) years of home health clinical, coding, or billing experience.
• OASIS certification (COS-C).Skills and Competencies
• Strong attention to detail and data integrity…