ICD-10 Coding Specialist (Home Health & Hospice) (Contract)

About the role

The Home Health and Hospice Coding Specialist is responsible for reviewing clinical documentation and assigning accurate ICD-10-CM diagnosis codes for home health and hospice patients. This contractor supports coding accuracy, regulatory compliance, reimbursement integrity, and quality outcomes by ensuring documentation supports the patient’s diagnoses, plan of care, level of service, and Medicare requirements.

Responsibilities

• Review home health and hospice clinical documentation across all time points (SOC, ROC, Recertification, Transfer, Discharge, Admission) to assign accurate ICD-10-CM diagnosis codes.
• Sequence diagnoses in strict compliance with ICD-10-CM guidelines, CMS requirements, PDGM payment methodologies, and hospice coding expectations.
• Audit clinical charts to identify documentation gaps or inconsistencies, and collaborate with clinical leadership or compliance teams to resolve query needs.
• Support revenue cycle efficiency by meeting established productivity and turnaround time goals to prevent delays in billing and claim submissions.
• Assist with internal quality assurance and external medical reviews, including TPE, ADRs, and compliance audits.
• Collaborate cross-functionally with clinical, QA, compliance, and revenue cycle teams to drive documentation integrity and regulatory readiness.

Requirements

• Experience: 2+ years in Home Health, ICD-10 coding, and OASIS review.
• Certification: Active HCS-D and HCS-O certifications.
• Skills: Extensive background in Plan of Care (POC) and HOPE documentation review.
• Knowledge Base: Comprehensive mastery of PDGM, Medicare CoPs, HHVBP, Star Ratings, and ICD-10 Official Coding Guidelines.

Qualifications

• Dual-specialty coding experience across both Home Health and Hospice care settings.
• Direct experience supporting TPE, ADR, medical reviews, and internal/external compliance audits.
• Proficiency in industry-standard EMRs (e.g., Homecare Homebase, WellSky, MatrixCare, Careficient, Netsmart).
• Solid understanding of OASIS accuracy, clinical quality measures, hospice documentation integrity, and billing-related coding guidelines.

Skills

• Professional Communication: Exceptional verbal and written communication skills tailored for cross-functional collaboration with clinical, quality, compliance, and billing teams.
• Independent Execution: Highly autonomous self-starter capable of managing priorities, meeting tight turnaround times, and executing responsibilities with minimal supervision.
• Clinical Accuracy: Strong clinical judgment paired with meticulous attention to detail.
• Risk Management: Proficient in proactive problem identification, timely escalation, and maintaining absolute confidentiality and HIPAA compliance.

Benefits

• Maintain an advanced, current knowledge base of CMS guidance, Medicare regulations, LCDs, and payer-specific updates.
• Ensure absolute data privacy and HIPAA compliance when handling all Protected Health Information (PHI).
• Generate and maintain tracking logs, status updates, and coding reports for management as required.

Pay

• Pay per chart: Minimum of six charts per day
• Coding only: $15 per chart
• Coding and OASIS/HOPE: $35 - $38 per chart (based on relevant experience)
• Coding/OASIS/HOPE/POC: $35 - $40 per chart (based on relevant experience)

Schedule

• No set hours; must meet established due dates on review assignments.

At-Will Employment

Employment with our organization is "at-will," meaning that either the employee or the employer may terminate the employment relationship at any time, with or without notice, and for any reason not prohibited by law.

Equal Employment Opportunity

We are an equal opportunity employer and are committed to creating an inclusive and diverse workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic as outlined by applicable laws.