Sheila Baje

Home Health Clinical Coordinator @AHH+C

🧨 Consulting

I am a Home Health Quality Assurance Nurse Specialist with 8 years of solid and substantial experience in clinical documentation review. I have been working with multiple home health agencies across the US since I started my career as a clinical QA in 2016. One of the highlights of my career that honed my expertise in clinical QA was being able to solely and single-handedly develop and approve the CMS-485 (Plan of Care) following Medicare guidelines within the 1-week turnaround time for a 130-census home health agency based in Illinois, along with in-depth chart audit including OASIS (SOC, Transfer, ROC, Recertication, Discharge), medication reconciliation, F2F and discipline notes using WellSky (formerly Kinnser) as the primary EMR. I am equally proficient with multiple EMRs including Axxess, Data Soft Logic, and DeVero. If there is one thing I can offer my clients in the home health industry on top of my expertise, it would be my strong and deep commitment to bring value to the table and deliver outstanding results as evidenced by my 6-year stint with a former home health agency based in IL.

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Work Background

Alternative Home Health + CareHome Health Clinical Coordinator

Oct. 2022Westmont, Illinois, United States- Update and maintain agency trackers (Hospitalization, Recertification/Discharge, Physician Orders) - Assist in the completion of all Physician Orders - Train QA nurses and Field Nurses on EMR and Documentation Protocol / Support QAs in Training Field Nurses - Back-up QA and OASIS/POC Reviewer

Alternative Home Health + CareQA Coordinator

Apr. 2022 - Oct. 2022Westmont, Illinois, United States-Prepared and transmitted medical records requested by Veterans Affairs Community Care for MD review -Collaborated with VA Community Care Nurses on required medical records for the approval of new authorizations -Conducted training of QA nurses and field nurses -Created documentation guidelines of clinical notes, POC and physician orders used during in-house training/services -Collaborated with field nurses regarding patient care and clinical documentation -Functioned as Back-up Intake and QA (Clinical Notes, POC/485, Physician Orders and OASIS SOC, REC, ROC, Transfer, DC) -Performed chart review and audit of clinical notes using Data Soft Logic EMR -Performed quarterly chart audits including Discharge Clinical Record Review and Quality Improvement Review

MD Solutions+ | Careforce Homehealth, Inc.Home Health QA

Jan. 2022 - Apr. 2022Lincolnwood, Illinois, United States- Performed chart review and audit of SN and HHA visit notes using Axxess EMR - Case management - Intake coordination - Preparation of chart for final billing - OASIS review (Start of Care, Recertification, Transfer, Resumption, Discharge)

Nationwide Health Care Consulting, Inc. | CareLink Home Health, LLCHome Health Quality Assurance Nurse Supervisor

Mar. 2016 - Jan. 2022Lopez Jaena St., Bacolod City | Schaumburg, Illinois, United States- Created and approved all Plans of Care (485) within the 1-week turnaround time for CareLink Home Health, LLC (120 to 130 census) in Illinois in line with regulatory standards and created goals and interventions according to patient needs and conditions including review of reconciled medications and F2F documentation - Formulated Plans of Care (485) with a weekly average of 40 and daily average of 8 - Performed chart audit of discipline notes to ensure completeness, accuracy, consistency and compliance to Medicare guidelines - Functioned as After-Hours Answering Service (from Oct 2020 to Jan 2022) handling calls concerning home health inquiries, patient referrals from hospitals, SNF/rehab facilities and MD office, visit confirmation and cancellation, patient complaints, hospitalization follow-ups, and calling in of critical lab results to MD office/clinics - Conducted 485 trainings, created weekly training reports and performed monthly evaluation of trainee performance - Proficient in WellSky (formerly Kinnser) - Collaborated effectively with agency staff, management and other members of the team - Handled all PCR / RCD for Health Team Corporation in Willowbrook, Illinois from Sept 2016 to Dec 2017 (16 claims for PCR request affirmed out of 20 submissions in a span of 3 months)

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