The Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
Department: Clinical Operations
Reports To: Director of Nursing (DON) / Clinical Manager
Requirements & Qualifications
Qualifications
- Current LVN or RN license preferred but not required, depending on agency needs.
- Certified Home Health Coding Specialist (HCS-D), COS-C, or equivalent certification preferred.
- Minimum of two years of home health experience.
- Minimum of one year of ICD-10 coding and OASIS review experience preferred.
- Thorough knowledge of Medicare Conditions of Participation and home health regulations.
- Strong understanding of ICD-10-CM coding guidelines.
- Experience with electronic medical record (EMR) systems.
- Excellent organizational, analytical, and problem-solving skills.
- Strong written and verbal communication skills.
- Ability to work independently while managing multiple priorities.
Knowledge, Skills, and Abilities
- Knowledge of Medicare reimbursement methodologies (PDGM).
- Proficiency in OASIS-E documentation and CMS regulations.
- Ability to identify documentation deficiencies and recommend corrective actions.
- Strong attention to detail and accuracy.
- Excellent time management and organizational skills.
- Ability to maintain strict confidentiality.
- Proficiency in Microsoft Office applications and EMR software.
Physical Requirements
- Prolonged periods of sitting and computer use.
- Ability to lift up to 20 pounds occasionally.
- Ability to communicate effectively by phone, video conference, and in person.
Location
California, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
Yes
Posted
1 month ago