Job Title/Position: Face-to-Face Nurse
JOB DESCRIPTION SUMMARY
The Face to Face Nurse is a nurse responsible for ensuring the agency’s compliance with the Face-to-Face requirement. The Face to Face nurse is vital in the intake/referral/admission/billing process to ensure episodes are valid. The Face-to-Face nurse works directly with the branch leadership, physician offices, portals, hospitals, sales team and rehabilitation facilities to ensure appropriate documentation is received and/or a new visit is coordinated. The Face-to-Face nurse also ensures appropriate valid PDGM Diagnoses are assigned to each patient by working with the Sales and Clinical Operators.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
1. Prospectively reviews all Face-to-Face documents to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy.
2. Utilizes PDGM guidelines and FTF Guidelines to ensure each patient has compliant and appropriate diagnoses.
3. Assigns and ensures appropriate ICD-10 coding and sequencing as it relates to the patient's medical condition, including any co-morbidities.
4. Consults with appropriate clinical staff to clarify any data integrity issues and works with clinician to make appropriate corrections per organization policy.
5. Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial lasses and/or underutilization to the clinical manager/designee.
6. Notifies organization leadership of problematic trends as a result of FTF reviews/precoding.
7. Works with managers and the sales team to address trends and educational issues with referral sources and sales staff.
8. Assists and provides education related to FTF and PDGM Compliant Diagnoses.
9. Participates in Quality improvement and Corporate Compliance activities as assigned.
10. Assists with other chart audit activities as assigned.
11. Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications.
POSITION QUALIFICATIONS
1. Registered Nurse or LVN with current license to practice professional nursing in TX/LA or CA.
2. One (1) to Iwo (2) years of clinical home health experience required.
3. Working knowledge of OASIS and ICD-10 coding.
4. OASIS certification (COS-C) or (HCS-O) preferred.
5. Home Health Care Coding certification (HCS-D) preferred.
6. Knowledge of federal regulations and state licensure requirements.
7. Working knowledge of computer systems.
8. Possess and maintains current CPR certification.
9. Licensed driver with automobile that is in good working order and insured in accordance with organization requirements.
10. Excellent coordination and communication skills.
11. Detail oriented and able to work with minimal supervision.