Quality Assurance RN

About the Company

Adaptive Home Health is building a higher-acuity, patient-centered home health model across Texas. We build technology to better support our clinical operations and compliance teams, using documentation and QA workflows designed to streamline OASIS review and maintain high-quality submissions.

Responsibilities

• Review and validate all assigned OASIS assessments (SOC, ROC, Recert, Transfer, Discharge) for accuracy and completeness
• Code and sequence diagnoses per ICD-10 and CMS guidelines to ensure optimal reimbursement
• Identify and correct errors impacting reimbursement, quality measures, or compliance
• Provide actionable feedback to field clinicians to support 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
• Support agency compliance with Conditions of Participation (CoPs) and internal quality standards
• Identify recurring documentation trends and contribute recommendations for workflow optimization
• Complete assigned OASIS reviews within defined turnaround times

Requirements

• Active, unrestricted Texas or compact RN license
• Minimum 2 years of home health experience
• COS-C and HCS-D (or equivalent) certifications required
• Strong understanding of Medicare home health reimbursement and PDGM
• Proficiency with EMR systems (HCHB preferred) and Microsoft Office
• Ability to work independently in a remote environment
• Reliable high-speed internet and HIPAA-compliant workspace

Preferred Qualifications

• 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