Remote-Eligible Home Health QA & Coding Specialist

Green Meadows Home Health Care Inc; Fountain Valley (CA); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Green Meadows Home Health Care Inc. is seeking a Home Health Quality Assurance (QA) / Coding Specialist to review clinical documentation for compliance with Medicare CoPs, state and federal regulations, and agency policies.

The role includes ICD-10 coding, OASIS review, chart audits, and supporting quality assurance initiatives to ensure accurate reimbursement and high-quality patient care. Strong attention to detail, communication skills, and the ability to work independently are essential.

Qualifications

• Two years of home health experience.
• One year ICD-10 coding and OASIS review experience preferred.
• Current LVN or RN license preferred.
• Certified HH coding certifications preferred.
• Strong knowledge of Medicare Conditions of Participation and home health regulations.
• Experience with EMR systems.
• Excellent organizational and communication skills.

Responsibilities

• Review patient records for completeness, accuracy, and regulatory compliance before billing.
• Conduct pre-bill and post-bill chart audits to ensure documentation supports skilled services.
• Ensure compliance with Medicare, Medi-Cal, CMS, ACHC/JCAHO (if applicable), and agency policies.
• Monitor documentation for timeliness, physician orders, signatures, and required certifications.
• Identify documentation deficiencies and communicate necessary corrections to clinical staff.
• Track quality indicators and assist with agency QAPI initiatives.
• Maintain audit logs and quality improvement reports.
• Assign accurate ICD-10-CM diagnosis codes based on physician documentation and clinical records.
• Review and validate primary and secondary diagnoses to ensure appropriate reimbursement.
• Verify coding accuracy for OASIS assessments and Plans of Care.
• Stay current with ICD-10 coding updates and CMS reimbursement guidelines.
• Collaborate with clinicians to clarify diagnoses and improve documentation specificity.
• Review Start of Care (SOC), Resumption of Care (ROC), Recertification, Transfer, Discharge, and Follow-Up OASIS assessments.
• Validate OASIS accuracy, consistency, and regulatory compliance.
• Ensure OASIS submissions are completed within CMS-required timeframes.
• Provide education and feedback to clinicians regarding OASIS documentation and scoring.
• Monitor agency compliance with Medicare Conditions of Participation.
• Assist in preparing documentation for surveys, audits, and accreditation reviews.
• Provide education and guidance to clinicians regarding documentation standards, coding updates, and regulatory changes.
• Participate in quality improvement meetings and interdisciplinary team discussions.
• Review physician orders, face-to-face documentation, certifications, recertifications, and plan of care documentation.
• Ensure documentation supports medical necessity and homebound status.
• Verify all required documentation is complete prior to claim submission.
• Maintain confidentiality in accordance with HIPAA regulations.

Skills

Quality assurance

Coding

OASIS review

Documentation accuracy

Regulatory compliance

Attention to detail

Time management

Education

RN/LVN license

HCS-D/COS-C certification

Tools

EMR systems

Microsoft Office

Job description

Green Meadows Home Health Care Inc. is seeking a Home Health Quality Assurance (QA) / Coding Specialist to review clinical documentation for compliance with Medicare CoPs, state and federal regulations, and agency policies.

The role includes ICD-10 coding, OASIS review, chart audits, and supporting quality assurance initiatives to ensure accurate reimbursement and high-quality patient care. Strong attention to detail, communication skills, and the ability to work independently are essential.