Remote Home Health QA & Coding Specialist

Home-Healthcare-Hospice-; Keene (NH); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Home Healthcare, Hospice and Community Services seeks a Quality Assurance and Coding Specialist to strengthen documentation quality, support compliant reimbursement, and improve patient outcomes in home health services.

In a collaborative role, you will audit, educate, and coach clinicians, validate OASIS and coding accuracy, and ensure compliance with CMS requirements across the agency.

Qualifications

• Current New Hampshire license in good standing as an RN, PT, or OT.
• COS-C certification.
• HCS-D certification.
• At least three years of home health experience.
• At least two years reviewing OASIS assessments and home health documentation.
• Demonstrated ICD-10-CM coding experience.
• Experience with clinical auditing, chart review, staff education, and regulatory compliance.
• Extensive knowledge of CMS Home Health CoP, OASIS guidance, and value-based purchasing programs.
• Strong analytical, auditing, problem-solving, organizational, communication, education, coaching, and mentoring skills.
• Ability to interpret Medicare regulations, analyze performance data, and drive improvements.
• Proficiency with EMR, OASIS software, and MS Office.
• Valid driver's license if travel is required.

Responsibilities

• Conduct pre-bill and post-bill clinical record audits for completeness, timeliness, and coding accuracy.
• Review Start of Care, Recertification, Follow-up, Transfer, and Discharge assessments for accuracy.
• Validate OASIS scoring per CMS guidance and reflect patient status.
• Review and validate diagnoses using ICD-10-CM guidelines and payer requirements.
• Ensure Plans of Care reflect patient needs, diagnoses, and outcomes.
• Collaborate with clinicians to clarify diagnoses and resolve deficiencies delaying billing.
• Serve as subject matter expert on OASIS, coding guidance, and regulatory updates.
• Develop and deliver OASIS, coding, and documentation education through training and coaching.
• Monitor performance trends and translate findings into improvement plans.
• Track HHPQI indicators and value-based purchasing metrics.
• Participate in QAPI, Clinical Documentation Improvement, and quality committees.
• Support survey readiness, audits, and leadership discussions.
• Maintain audit findings and quality dashboards with timely data submission.
• Cross-train on HOPE assessments and provide hospice coverage as needed.

Skills

OASIS

ICD-10-CM coding

clinical documentation

auditing

coaching

education

regulatory compliance

CMS guidance

analytical skills

EMR systems

Education

Registered Nurse license (NH)

COS-C (OASIS Specialist-Clinical)

HCS-D (Home Care Clinical Specialist - Diagnosis Coding)

Tools

OASIS software

Microsoft Office

Job description

Home Healthcare, Hospice and Community Services seeks a Quality Assurance and Coding Specialist to strengthen documentation quality, support compliant reimbursement, and improve patient outcomes in home health services.

In a collaborative role, you will audit, educate, and coach clinicians, validate OASIS and coding accuracy, and ensure compliance with CMS requirements across the agency.