Quality Assurance Specialist (RN) Weekends

Adaptive Home Health • Houston, TX

3d • Remote

About The Position

Adaptive Home Health is seeking a Quality Assurance Specialist (RN) to join their team. This role is crucial in ensuring clinical accuracy, regulatory compliance, and optimal reimbursement within a patient-centered home health model. The QA RN will support field clinicians by providing actionable feedback and driving continuous quality improvement. The company utilizes technology to enhance clinical operations and compliance, with streamlined workflows for OASIS review, reduced rework, and high-quality submissions. This remote, productivity-based role is ideal for individuals with strong clinical judgment, deep OASIS expertise, and a desire to impact patient outcomes and agency performance.

Requirements

• Active, unrestricted Texas RN license
• Minimum 2 years of home health experience
• ICD-10 Coding Certification (HCS-D or equivalent)
• OASIS Certification (COS-C or equivalent)
• Strong understanding of Medicare home health reimbursement and PDGM
• High attention to detail and strong clinical judgment
• Ability to work independently in a remote environment with minimal supervision
• Excellent written and verbal communication skills
• Proficiency with EMR systems (HCHB preferred) and Microsoft Office
• Ability to work at a computer for extended periods
• Reliable high-speed internet access and secure, HIPAA-compliant workspace
• Proficiency with EMR systems, Microsoft Office, and virtual communication tools (Slack, Zoom, etc.)

Nice To Haves

• Prior experience in home health QA, auditing, or coding
• Familiarity with Homecare Homebase (HCHB) or AXXESS
• Experience working in a per-review or productivity-based role
• Background in OASIS education or clinician training

Responsibilities

• Review and validate all assigned OASIS assessments (SOC, ROC, Recert, Transfer, Discharge) for accuracy, completeness, and internal consistency.
• Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement and quality measure alignment.
• Identify and correct errors impacting reimbursement, quality measures, or compliance before submission.
• Provide clear, actionable feedback to field clinicians when revisions are required, with a focus on education and process improvement.
• Ensure all OASIS submissions meet current CMS, Medicare, and payer requirements.
• Stay current on OASIS updates, CMS guidance, and regulatory changes; communicate relevant updates to clinical leadership.
• Support agency compliance with Conditions of Participation (CoPs) and internal quality standards.
• Identify recurring documentation trends or risk areas and contribute recommendations for clinician training and workflow optimization.
• Collaborate with clinical leadership to improve outcomes, reduce audit risk, and maintain defensibility.
• Complete assigned OASIS reviews within defined turnaround times while maintaining high accuracy standards.
• Communicate promptly and professionally with clinicians and leadership regarding discrepancies, missing documentation, or process improvements.

Benefits

• Clear, performance-based comp: $35 per locked OASIS review—earn based on quality and productivity
• Remote flexibility: Work from home with flexible hours designed to scale with agency census (Prefer Texas-based)
• Mission-driven impact: Directly influence patient care quality, clinician development, and agency compliance
• Strong operational support: Collaborate with experienced clinical and compliance leadership
• Tech-forward environment: Leverage tools designed to streamline QA workflows and reduce administrative burden

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed