RN Medical QA (OASIS) | Home Health | US Campaign | BPO

Job description:

OASIS RN QA

• Department: Clinical Quality / OASIS QA
• Employment Type: Full-time
• Location: Parañaque City - On-site.
• Reports to: Clinical Supervisor/Nursing Supervisor

Job Overview

The OASIS QA Registered Nurse is responsible for reviewing and ensuring the accuracy, completeness, and compliance of OASIS-E1 documentation and associated clinical visit narratives completed by field clinicians.

This role supports regulatory compliance, payer requirements, and internal documentation standards through structured chart review, ICD-10 coding validation, and real-time monitoring of visit documentation for active patients.

This is a non-bedside, quality assurance role focused on documentation governance, clinical accuracy, and risk mitigation.

Key Responsibilities

• Review OASIS-E1 Start of Care (SOC) and Resumption of Care (ROC) documentation for completeness, accuracy, and compliance
• Validate and correct ICD-10 diagnosis coding based on referral documentation,MD orders, and clinical records
• Ensure all visit documentation includes required clinical elements:wound status update (with photo if applicable)

- vital signs, visit events, medication reconciliation, general health assessment (pain, cardiovascular, neurological, GI/GU,integumentary), skilled interventions performed, patient/caregiver education, EVV / visit verification

• Review and complete clinical narratives for assigned SOC and ROC charts
• Monitor active patient charts in Axxess in real time to ensure visit documentation is complete and compliant
• Identify documentation gaps and return charts for correction with clear QA feedback
• Flag and escalate critical documentation errors that may affect compliance or reimbursement
• Collaborate with Clinical Operations, Intake, Billing, and QA teams to ensure documentation readiness for billing

Scope of Review

Included:

• OASIS-E1 Start of Care (SOC)
• OASIS-E1 Resumption of Care (ROC) (within 7 days of facility discharge)

Excluded:

• Recertifications
• Discharges
• Routine non-OASIS visits (except for visit documentation QA monitoring)

Volume & Turnaround Expectations

• QA reviews are based on all active patients within Axxess, not assigned patient panels
• Workload is dependent on daily visit frequency and census
• Clinical narratives must be completed within 48 hours of submission
• Visit documentation QA monitoring is expected in real-time / same-day review visibility

Required Qualifications

Education & Licensure : Active, unrestricted Philippines Registered Nurse (RN) license

Minimum Required Experience

Candidates must meet the following combined experience structure:

Clinical (Bedside) Experience

Minimum 1-2 years bedside nursing experience

• Acceptable clinical areas include:
• o Medical-Surgical
• o Emergency Room
• o Operating Room
• o Orthopedics
• General Surgery
• o Stepdown / ICU

QA / Coding / OASIS Experience — REQUIRED

• Minimum 1.5 years experience in at least one of the following:
• OASIS documentation review
• ICD-10 coding (home health or post-acute)
• Clinical documentation QA / audit

Core Skills

• Strong clinical documentation and chart review skills
• ICD-10 coding familiarity and validation skills
• EMR/EHR proficiency (Axxess experience preferred)
• Strong understanding of medical necessity and skilled documentation
• Strong written communication and structured clinical writing
• Ability to provide clear, constructive QA feedback

Preferred (Not Required)

• Home health or post-acute care experience
• Medicare / Medi-Cal documentation standards knowledge

Scope Limitations

• No direct patient care
• No case management assignment
• No clinician supervision responsibilities

Acceptable Experience Combinations

The following ratios are acceptable:

• 1:1.5 (Bedside: QA/Coding/OASIS)
• 1.5:1.5
• 2:1.5 or higher

Candidates with less than 1 year bedside experience, or less than 1.5 years QA/coding/OASIS experience will not be considered.