Home Health Care Coordinator (Clinical QA)

About the role

A US Medicare-certified home health agency is looking for a Home Health Care Coordinator with a clinical background and hands-on quality assurance experience. The role focuses on clinical QA review, while also supporting intake, scheduling and prior authorizations. It is remote, part-time, Monday to Friday, 10:30 AM to 3:30 PM Eastern time (5 hours per day).

Key responsibilities

• Clinical QA review: check clinical records for completeness, accuracy and Medicare compliance before billing.
• Audit OASIS assessments (SOC, ROC, recertification, transfer, discharge) for accuracy and consistency with clinical documentation.
• Review plans of care for complete orders, physician signatures and alignment with visit frequencies.
• Verify that homebound status and face-to-face encounter documentation are supported in the record.
• Identify documentation deficiencies, communicate corrections to clinicians and track them to resolution.
• Track outstanding physician orders and signatures, flag missed visits and frequency deviations.
• Support CHAP survey readiness and Medicare audit/ADR record preparation.
• Process referrals, verify insurance eligibility and confirm admission documents are received.
• Obtain, track and renew prior authorizations for Medicare Advantage and commercial payers.
• Coordinate clinician visit schedules and manage reschedules and cancellations.

Required profile

• RN strongly preferred; PT, OT or LPN considered.
• Minimum 2 years of experience in a Medicare-certified home health agency in the US.
• Demonstrated experience performing clinical QA/chart review for home health.
• Working knowledge of OASIS, Medicare Conditions of Participation (42 CFR 484) and PDGM.
• Excellent written and spoken English, comfortable communicating with clinicians and physician offices.
• HIPAA knowledge, willingness to sign confidentiality and security agreements, reliable high-speed internet and a private, secure workspace.
• Preferred: OASIS certification (COS-C or HCS-O), CHAP or Joint Commission survey experience, and prior authorization experience with Medicare Advantage plans.

Required skills

• Experience with a home health EMR such as WellSky/Kinnser, HCHB or Axxess.
• OASIS documentation review.

What we offer

• Immediate hiring.
• Permanent work from home.
• Hourly pay set after the application process; applicants who meet all requirements are reviewed first.