Qualifications

Required:

• Active RN, LVN/LPN, or certified medical coder (e.g., CPC, CCS, HCS-D) credential
• Minimum 2 years experience in the Home Health Quality Assurance
• Minimum 2 years of experience in Home Health coding (ICD-10, OASIS)
• Strong knowledge of Medicare guidelines, PDGM, and regulatory compliance
• Proficient with computers and applications: Microsoft Office Suites, Google Applications, etc.
• Tech Savvy – ability to learn new systems including Electronic Medical Systems
• Demonstrates a "growth mindset," with a proactive attitude towards learning and improving skills, coupled with a strong sense of personal responsibility and initiative in achieving goals.
• Ability to train and educate clinical staff on coding best practices

Desired:

• HCS-D or BCHH-C certification (Home Health-specific coding credentials)
• Experience with WellSky, Axxess, Homecare Homebase, or similar EHRs
• Background in Quality Assurance, Utilization Review, or Compliance

Your Day to Day Activities

QA Specialist will review medical records to ensure they are complete and accurate. To achieve this, QA must be detailed oriented and work closely with the clinical staff.

Specific activities include:

• Review and code Home Health patient records, ensuring accuracy and compliance with ICD-10, OASIS, and PDGM guidelines.
• Conduct reimbursement optimization reviews to ensure accurate coding of primary and comorbid conditions that impact case mix weight and PDGM payment calculation.
• Audit clinical documentation for completeness, proper diagnosis coding, and alignment with Medicare and regulatory standards.
• Collaborate with clinicians to clarify documentation and provide guidance on proper coding practices.
• Identify and correct coding errors, inconsistencies, or missing information in patient records.
• Educate and train nurses, therapists, and other clinical staff on best practices for coding and documentation.
• Monitor regulatory updates and ensure the agency remains compliant with Medicare, Medicaid, and payer requirements.
• Work with QA and compliance teams to improve documentation accuracy and reimbursement optimization.
• Utilize EHR systems (e.g., WellSky, Homecare Homebase) to review, document, and update patient records.
• Assist in pre-bill audits to reduce denials and optimize revenue cycle performance.

What you can expect:

· Competitive monthly salary of $900 per month

· Fully remote

· Career mobility - potential for promotions and salary adjustments

· Work schedule aligned with US business hours (specify time zone and shift hours)

Job Types: Full-time, Permanent

Pay: Up to Php52,528.00 per month

Benefits:

• Opportunities for promotion
• Pay raise
• Promotion to permanent employee
• Work from home

Application Question(s):

• Please confirm if you are selected for an interview, you are comfortable with being on video and role playing. Also confirm that if you cannot make the video you will notify the interviewer prior.
• Please also confirm you accept the hours - US Pacific time 9:00 am to 6:00 pm, or 7:00 am to 4:00 pm. Please confirm you have reliable Internet.
• Please list your availability for a video interview in US Pacific Times. Please give a wider range with various days and times during Pacific business hours (8:00 am - 6:00 pm)

Experience:

• Home Health QA: 2 years (Required)
• Home Health Medical Coding: 1 year (Required)
• Wellsky/Kinnser: 1 year (Preferred)
• Axxess: 1 year (Preferred)

License/Certification:

• Nursing license (Required)

Work Location: Remote