Home Health QA RN - OASIS & Coding

AdminEdge; Metro Manila; Remote; PHP 606,000 - 692,000; Part time

Benefits offered by this job

Competitive pay (USD)

Fixed U.S. schedule

Fully remote - work from anywhere

US-based collaboration

PTO - 10 days + 6 holidays

Job summary

AdminEdge is seeking a Home Health QA RN - OASIS & Coding to support a U.S.-based Medicare-certified home health agency. The role primarily reviews and validates OASIS assessments and clinical documentation for CMS compliance, accuracy, and completeness.

The ideal candidate is an experienced Registered Nurse with hands-on OASIS QA experience for U.S.-based agencies, able to independently review assessments, identify discrepancies, and communicate corrections to clinicians.

Qualifications

• Minimum 3+ years of recent experience supporting U.S.-based home health agencies.
• Direct hands-on experience reviewing or scrubbing OASIS assessments.
• Experience performing home health clinical QA and chart review.
• Experience with diagnosis coding for OASIS assessments.
• Strong understanding of Medicare home health documentation requirements.
• Experience reviewing Start of Care documentation.

Responsibilities

• Review OASIS assessments for accuracy, completeness, consistency, and clinical support.
• Verify OASIS responses are supported by clinical documentation and findings.
• Identify missing, conflicting, or potentially inaccurate OASIS responses.
• Review assessments for proper sequencing and cross-document consistency.
• Identify discrepancies between OASIS responses, Plan of Care, notes, diagnoses, and documentation.
• Communicate discrepancies to clinicians for clarification and correction.
• Follow up until corrections are resolved and ready for finalization.
• Ensure corrections comply with CMS and agency requirements.
• Review OASIS assessments for timely completion within regulatory timeframes.
• Monitor patterns of OASIS errors and provide feedback to clinicians.
• Provide ongoing education to clinical staff regarding OASIS requirements.
• Communicate CMS OASIS changes to staff and assist with orientation.
• Assist with competency activities related to OASIS documentation.
• Provide constructive feedback on documentation accuracy.
• Maintain professional communication with clinical staff and management.
• Provide secondary support with intake, scheduling, authorizations when volume permits.

Skills

Registered Nurse

English communication

Detail-oriented

Queue management

Job description

Position: Home Health QA RN - OASIS & Coding

Job Type:Part-time (25 hours/week, with growth within 4-6 months)

Location:Philippines (Remote, EST hours)

Salary: $7/hr - $8/hr

*****IMPORTANT*****

Overview

We are seeking an experienced Home Health QA RN - OASIS & Coding to support a growing U.S.-based, Medicare-certified home health agency. This role is primarily responsible for reviewing and validating OASIS assessments and clinical documentation for accuracy, completeness, clinical consistency, and compliance with applicable CMS requirements.

The ideal candidate is an experienced Registered Nurse with direct hands-on experience performing OASIS QA for U.S.-based home health agencies. This person should be comfortable independently reviewing assessments, identifying documentation discrepancies, supporting diagnosis coding, and communicating corrections directly with clinicians. Broader experience with intake, scheduling, authorizations, and other home health administrative workflows is valuable but secondary to OASIS QA expertise.

Key Responsibilities

OASIS Review & Quality Assurance

• Review OASIS assessments for accuracy, completeness, consistency, and clinical support.
• Verify that OASIS responses are supported by the patient's clinical documentation and assessment findings.
• Identify missing, conflicting, inconsistent, or potentially inaccurate OASIS responses.
• Review assessments for appropriate clinical sequencing and consistency across the assessment.
• Identify discrepancies between OASIS responses, the Plan of Care, visit notes, medication profile, diagnoses, and other clinical documentation.
• Communicate identified discrepancies to the appropriate clinician for clarification and correction.
• Follow up until corrections are resolved and the assessment is ready for finalization.
• Ensure corrections are completed in accordance with applicable CMS and agency requirements.
• Review OASIS assessments for appropriate completion within required regulatory timeframes.
• Monitor patterns of OASIS errors and provide feedback to clinicians.

Market Research & Lead Qualification

• Review diagnoses documented in the clinical record for appropriate ICD-10-CM coding.
• Ensure diagnoses selected for home health documentation are supported by the patient's medical record and Plan of Care.
• Review diagnosis sequencing for consistency with the patient's clinical condition and reason for home health services.
• Identify unsupported, incomplete, or conflicting diagnoses and communicate with appropriate clinical personnel for clarification.
• Ensure coding practices remain consistent with current CMS requirements and applicable coding guidelines.
• Collaborate with clinical and billing teams regarding diagnosis and coding issues that may affect claims or reimbursement.

Clinical Documentation & Compliance

• Review clinical documentation for compliance with Medicare Conditions of Participation and applicable CMS requirements.
• Ensure consistency between the OASIS assessment, comprehensive assessment, Plan of Care, medication profile, and visit documentation.
• Monitor documentation for evidence supporting medical necessity, skilled services, homebound status, and the patient's Plan of Care.
• Identify documentation deficiencies that may create regulatory, billing, or quality risks.
• Escalate significant or unresolved documentation concerns to the appropriate clinical leadership.
• Maintain confidentiality and comply with HIPAA and agency privacy policies.

Clinician Education & Support

• Provide ongoing education to clinical staff regarding OASIS requirements and documentation expectations.
• Communicate changes in CMS OASIS requirements, coding guidelines, and agency policies to appropriate staff.
• Assist with orientation and competency activities related to OASIS documentation.
• Provide constructive feedback to clinicians regarding documentation and assessment accuracy.
• Maintain professional communication with clinical staff and management.

Home Health Operational Support

• Provide secondary support with intake, scheduling, authorizations, and other clinical-administrative home health workflows when QA volume permits.
• Assist with other operational needs as appropriate while maintaining OASIS QA and diagnosis coding as the primary focus of the role.

Preferred Skills & Qualifications

• Registered Nurse (RN).
• Minimum 3+ years of recent experience supporting U.S.-based home health agencies
• Direct hands-on experience reviewing or scrubbing OASIS assessments.
• Experience performing home health clinical QA and chart review.
• Experience with diagnosis coding associated with OASIS assessments.
• Strong understanding of Medicare home health documentation requirements.
• Experience reviewing Start of Care documentation.
• Ability to identify inconsistencies between OASIS responses, clinical documentation, diagnoses, and Plan of Care information.
• Experience communicating QA findings and requested corrections directly to clinicians.
• Familiarity with U.S. home health EMR workflows.
• Strong written and verbal English communication skills.
• Highly detail-oriented, methodical, and capable of managing a queue of assessments independently.
• Reliable computer, stable internet connection, and dependable backup connectivity.

Nice-to-Have (Bonus Skills)

• OASIS certification.
• Home health coding certification.
• Several years of experience specifically dedicated to OASIS QA/review.
• Experience supporting multiple U.S.-based home health agencies.
• Experience reviewing multiple OASIS assessment types beyond Start of Care.
• Advanced knowledge of diagnosis sequencing.
• Experience providing OASIS or documentation education and feedback to field clinicians.
• Familiarity with intake, scheduling, insurance verification, and authorizations.
• Experience working remotely during U.S. business hours.

What we offer:

• Competitive compensation - $7-$8 per hour, paid in USD
• Fixed U.S. working schedule
• Fully remote role - work from anywhere
• Direct collaboration with U.S. small businesses and entrepreneurs
• Paid time off - 10 PTO days per year, plus 6 U.S. holidays off