In this role, you will:

• Review all forms and clinical records for client’s reimbursement.
• Reference OASIS assessment and patient’s therapy evaluation for accuracy and completeness of each visit notes.
• Audit charts for clinical oversight, compliance and adherence to the US Medicare guidelines.
• Identify clinical problem areas and document deficiency trends.
• Communicate with clients’ administrative and clinical associate staff in the correction of any such deficiencies.
• Submit daily QA worklog report.

To be successful in this role you will need:

• Bachelor’s degree in Nursing with active PRC license
• At least 1 year clinical experience, preferably in the adult medical-surgical area
• Skilled in providing effective nursing care, assessing patient situations
• Strong critical and analytical thinking skills
• Willing to undergo training in nursing QA review and Medicare guidelines
• Overseas clinical experience A PLUS, but not required
• Experience in a Healthcare BPO is A PLUS, but not required
• Working knowledge of Medicare home health requirements A PLUS, but not required
• Active USRN license A PLUS, but not required

As an employer of choice, we will provide you:

• Enjoy weekends off
• Great opportunity at senior level
• Day shift from 7AM – 4PM
• Healthcare BPO (back office)
• Paid vacation leaves upon hired
• Attendance Incentives
• HMO insurance
• Great Team Environment
• Work-life balance culture ( team buildings, seminars, trainings, engagement activities)

The post Nurse QA Specialist first appeared on Qavalo.

In this role, you will:

• Review all forms and clinical records for client’s reimbursement.
• Reference OASIS assessment and patient’s therapy evaluation for accuracy and completeness of each visit notes.
• Audit charts for clinical oversight, compliance and adherence to the US Medicare guidelines.
• Identify clinical problem areas and document deficiency trends.
• Communicate with clients’ administrative and clinical associate staff in the correction of any such deficiencies.
• Submit daily QA worklog report.

• At least 1 year clinical/hospital experience
• Active PRC license is a plus
• Willing to undergo training
• Analytical, detail-oriented, organized and can work well under pressure
• Ability to work independently with minimal supervision, but also in a team environment
• Familiarity in navigating electronic medical records is a plus but not required
• Working knowledge of Medicare home health guidelines a plus but not required

The post Allied Health Professionals as Medical Chart Reviewer first appeared on Qavalo.