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TYPE OF WORK
Full Time
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SALARY
5$/hr
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HOURS PER WEEK
40
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DATE UPDATED
Jul 30, 2026
Home Health – Quality Assurance Associate
Position Summary
The Home Health Quality Assurance (QA) Associate is responsible for reviewing, correcting, and completing clinical documentation to ensure compliance, accuracy, and audit-readiness across the home health episode. This includes Plans of Care (POC), OASIS assessments, skilled nursing (SN) documentation, peripheral clinical forms, and billing-related documentation support. The QA Associate works closely with agency clinical staff and the billing team to resolve documentation discrepancies prior to final claims submission.
Key Responsibilities
1. Plan of Care (POC) Review and Creation
Complete the Plan of Care based on referral, admission order, and visit schedule.
Verify that the correct discipline (SN/PT/OT/ST) and visit frequency are documented, cross-referencing the visit calendar, referral attachment, or admission order.
Develop appropriate interventions and goals based on coded diagnoses and the RN's OASIS assessment.
Note: Obtaining the physician's (MD) signature on the completed POC remains the agency's responsibility.
2. OASIS Review
Review, correct, and complete OASIS assessments (assessments must be 70–80% complete prior to QA review).
Confirm that assigned diagnoses align with M-codes and GG-codes.
Validate, lock, and mark OASIS documents as export-ready.
Note: Exporting the OASIS into iQIES remains the client/agency's responsibility; QA staff do not request or use iQIES login credentials.
For Transfer (TOC) and Discharge (DC) OASIS, ensure the assessment is not left blank and that the reason for transfer or discharge is documented either within the OASIS or in the MD order.
3. Skilled Nursing (SN) Note Review
Review SN notes for completeness, accuracy, and compliance with the Plan of Care.
Confirm documentation appropriately reflects the patient's clinical case.
Identify and eliminate duplication within SN narratives.
Perform direct edits to notes and complete missing sections as needed.
Note: Agency staff are responsible for e-signing any notes edited or reopened by QA.
4. Peripheral QA Documentation
Prepare the following documents based on agency request, preference, or clinical need:
Recertification attestation (Recert episodes)
Initial case conference (upon Start of Care)
LVN supervisory note (every 30 days, if applicable)
CHHA care plan (if CHHA referral present)
CHHA visit notes (if applicable)
CHHA supervisory note (every 14 days, if applicable)
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Infection control report (new infections or new antibiotic orders mid-episode)
Transfer summary (optional, per agency preference, for TOC)
Case conference (upon Resumption of Care)
30-day summary/progress report (optional, per agency preference)
60-day summary/progress report (for recertified episodes)
Discharge summary (for episodes ending in discharge)
5. Billing-Support (Deep Tech) QA
Coordinate with the agency's billing department to receive and resolve documentation issues prior to final claims billing.
Correct discrepancies between ordered visit frequency and posted actual visits.
Draft and post communication notes or MD orders to address missed visits or justify changes in visit frequency, and complete other non-clinical corrections needed to support final claims (FC) billing.
Return resolved issue lists to the biller in a timely manner.
Escalate to the client/agency any issues requiring physician signature, OASIS export, or posting of actual visits, as these functions are handled in-house by the agency (e.g., faxing/receiving MD orders, uploading signed documents to the EMR, exporting OASIS via iQIES, and posting actual visits to the calendar).
Qualifications
Background in home health clinical documentation, OASIS, or quality assurance preferred.
Working knowledge of home health regulatory and documentation standards (CMS, OASIS, M-codes, GG-codes).
Strong attention to detail and ability to identify documentation discrepancies.
Familiarity with EMR systems used in home health.
Knowledge of or experience with billing for Kaiser Permanente preferred but not required.
Strong written communication skills for clinical note editing and physician order drafting.
Ability to coordinate effectively with agency staff and billing partners.
Scope Boundaries
QA staff do not export OASIS via iQIES and do not request iQIES login access.
QA staff do not obtain physician signatures, fax/receive documents to/from MD offices, or post actual visits — these remain agency responsibilities.
Notes edited or reopened by QA require agency staff e-signature to finalize.
