Nurse | Multidisciplinary Clinical QA (RN, PT, OT., ST) | BPO | US Home Health

Job description:

Department: Clinical Quality/Multidisciplinary QA

Employment Type: Full-time

Location: Parañaque City - On-site

Reports to: Clinical Supervisor/QA Supervisor

Job Overview

The Multidisciplinary QA Reviewer is responsible for reviewing and ensuring the accuracy, completeness, and compliance of interdisciplinary home health documentation and associated clinical visit narratives completed by field clinicians.

This role supports Medicare and Medicaid regulatory compliance, payer requirements, and internal documentation standards through structured chart review, OASIS validation, interdisciplinary documentation monitoring, and real-time QA oversight for active patients.

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

Key Responsibilities

• Review interdisciplinary documentation for completeness, accuracy, and compliance
• Review documentation from:
• - Skilled Nursing (RN)
• - Physical Therapy (PT)
• - Occupational Therapy (OT)
• - Speech Therapy (ST)
• Review and validate OASIS-E1 / OASIS-E2 documentation
• Ensure documentation aligns with:
• - physician orders
• - plan of care
• - visit frequency
• - skilled interventions
• - functional goals
• Review interdisciplinary clinical narratives and visit documentation for medical necessity and skilled service justification
• Monitor active patient charts in real time to ensure documentation readiness and compliance
• Identify documentation gaps and return charts for correction with structured QA feedback
• Flag and escalate critical documentation concerns that may impact compliance, reimbursement, or billing readiness
• Collaborate with Clinical Operations, Intake, Billing, and QA teams to ensure documentation readiness for submission cycles

Scope of Review

Included:

• OASIS-E1/OASIS-E2
• RN documentation
• PT documentation
• OT documentation
• ST documentation
• ROC/REC
• Transfers / Discharges
• Physician order alignment
• Plan of care validation

Excluded:

• Direct patient care responsibilities
• Non-skilled wellness visits

Volume & Turnaround Expectations

• QA reviews are based on all active patients within the operational census
• Workload is dependent on daily visit frequency and census volume
• Documentation QA monitoring is expected in real-time / same-day review visibility whenever operationally applicable
• Documentation must be reviewed and corrected prior to billing submission whenever applicable
• QA review must account for hospitalization, transfer, recertification, discharge, and care status changes

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:

- Medical-Surgical

- Emergency Room

- ICU / Stepdown

QA / OASIS / Documentation Experience

REQUIRED

• Direct experience with OASIS-E1 / OASIS-E2 documentation review, completion, or management
• Strong familiarity with Medicare / Medicaid documentation processes and home health compliance standards
• Experience in at least one of the following:

- OASIS documentation review

- Clinical documentation QA/ audit

- Home health documentation management

- Utilization review

- Interdisciplinary chart review

Core Skills

• Strong clinical documentation and chart review skills
• Strong understanding of home health documentation standards and medical necessity requirements
• Ability to review interdisciplinary documentation across RN, PT, OT, and ST services
• Strong written communication and structured clinical writing skills
• Ability to provide clear, constructive QA feedback
• Strong attention to detail and escalation judgment
• EMR/EHR proficiency

Preferred (Not Required)

• US-based home health or post-acute remote care experience
• Familiarity with US-based interdisciplinary home health workflows
• Experience supporting billing readiness and documentation compliance review

Scope Limitations

• No direct patient care
• No case management assignment
• No clinician supervision responsibilities
• Role is strictly focused on documentation QA, compliance review, auditing, and escalation per protocol

Acceptable Experience Combinations

The following minimal ratios are acceptable:

1:1 / 2:1 / 1:2