Remote Home Health Clinical Operations & QA Specialist (USRN)

We are seeking an experienced, detail-oriented Remote Filipino USRN to provide high-level clinical, administrative, and operational quality assurance support for our U.S.-based home health organization. In this role, you will manage our end-to-end back-office clinical workflows and chart movement within the WellSky/Kinnser EHR platform—from patient intake and Face-to-Face (F2F) verification to CMS-485 Plan of Care auditing, interim order creation, and clinician follow-ups.
This is a part-time, remote position (20 hours per week) ideal for a highly organized, independent nurse who understands the strict compliance deadlines of Medicare-certified agencies and can seamlessly handle the administrative chart flow so our local clinical leadership and field teams can focus on direct patient care.
Key Responsibilities
Quality Assurance & Chart Review Flow
WellSky Workflow Management: Audit daily skilled nursing and therapy progress notes within the WellSky workflow bucket for clinical accuracy, completeness, consistency, and compliance.
OASIS & CMS-485 Auditing: Review field clinician assessments to build, draft, and finalize comprehensive CMS-485 Plans of Care. Ensure documentation deficiencies or discrepancies are flagged early to support billing, survey readiness, and timely reimbursement.
Clinician Coordination & Chasing: Track documentation deficiencies and proactively follow up with field clinicians via phone, text, or email to chase missing progress notes, get clarifications, and correct rejected charts.
Orders & Compliance Management
Interim Order Creation: Independently identify, draft, and manage necessary interim or supplemental physician orders within WellSky (e.g., changes in visit frequency, new medications, specialized wound care supplies).
Physician Tracking: Route generated CMS-485s and interim orders to primary care physicians for signatures via electronic methods (e-fax, DocuSign), and aggressively track them to ensure compliance deadlines are never missed.
Status Updates & Discharges: Execute immediate EHR status updates and operational checklists when a patient is admitted, transferred to an inpatient facility, discharged, or passes away.
Intake & Authorizations Support
Referral & F2F Verification: Support the intake pipeline by reviewing incoming hospital discharge records and identifying if the Face-to-Face (F2F) encounter notes legally satisfy Medicare eligibility criteria.
Prior Authorizations: Assist with insurance authorization workflows, including organizing clinical data, submitting requests to managed care portals, and tracking pending approvals.
Required Qualifications & Skills
Active Licensing: Active status as a Registered Nurse (RN) with a valid USRN license (passed NCLEX-RN) and an active PHRN license.
EHR Software Expertise: Hands-on, proficient experience navigating the WellSky / Kinnser home health platform is highly preferred.
Home Health Experience: Minimum of 1–2 years of experience handling U.S. home health quality assurance (QA), chart auditing, utilization review, or clinical documentation support.
Regulatory Compliance: Solid understanding of CMS guidelines, OASIS documentation, F2F criteria, and medical necessity rules.
Communication: Exceptional written and spoken English communication skills, with a confident professional presence when communicating with internal stakeholders and US physician offices.
Technical Setup: Dedicated, private remote workspace with a high-speed primary internet connection and a reliable backup internet option. High commitment to data security and strict compliance with HIPAA privacy standards.
Job Details
Job Type: Part-Time (20 hours/week)
Location: Philippines (Fully Remote)
Schedule: [Specify your preferred hours here, e.g., U.S. EST/CST Daytime hours or flexible shift]
Target Salary Rate: $7.00 – $8.00 / hour (or locally positioned at ₱37,000 – ₱42,000 per month pro-rated for part-time)
We are seeking an experienced, detail-oriented Remote Filipino USRN to provide high-level clinical, administrative, and operational quality assurance support for our U.S.-based home health organization. In this role, you will manage our end-to-end back-office clinical workflows and chart movement within the WellSky/Kinnser EHR platform—from patient intake and Face-to-Face (F2F) verification to CMS-485 Plan of Care auditing, interim order creation, and clinician follow-ups.
This is a part-time, remote position (20 hours per week) ideal for a highly organized, independent nurse who understands the strict compliance deadlines of Medicare-certified agencies and can seamlessly handle the administrative chart flow so our local clinical leadership and field teams can focus on direct patient care.
Key Responsibilities
Quality Assurance & Chart Review Flow
WellSky Workflow Management: Audit daily skilled nursing and therapy progress notes within the WellSky workflow bucket for clinical accuracy, completeness, consistency, and compliance.
OASIS & CMS-485 Auditing: Review field clinician assessments to build, draft, and finalize comprehensive CMS-485 Plans of Care. Ensure documentation deficiencies or discrepancies are flagged early to support billing, survey readiness, and timely reimbursement.
Clinician Coordination & Chasing: Track documentation deficiencies and proactively follow up with field clinicians via phone, text, or email to chase missing progress notes, get clarifications, and correct rejected charts.
Orders & Compliance Management
Interim Order Creation: Independently identify, draft, and manage necessary interim or supplemental physician orders within WellSky (e.g., changes in visit frequency, new medications, specialized wound care supplies).
Physician Tracking: Route generated CMS-485s and interim orders to primary care physicians for signatures via electronic methods (e-fax, DocuSign), and aggressively track them to ensure compliance deadlines are never missed.
Status Updates & Discharges: Execute immediate EHR status updates and operational checklists when a patient is admitted, transferred to an inpatient facility, discharged, or passes away.
Intake & Authorizations Support
Referral & F2F Verification: Support the intake pipeline by reviewing incoming hospital discharge records and identifying if the Face-to-Face (F2F) encounter notes legally satisfy Medicare eligibility criteria.
Prior Authorizations: Assist with insurance authorization workflows, including organizing clinical data, submitting requests to managed care portals, and tracking pending approvals.
Required Qualifications & Skills
Active Licensing: Active status as a Registered Nurse (RN) with a valid USRN license (passed NCLEX-RN) and an active PHRN license.
EHR Software Expertise: Hands-on, proficient experience navigating the WellSky / Kinnser home health platform is highly preferred.
Home Health Experience: Minimum of 1–2 years of experience handling U.S. home health quality assurance (QA), chart auditing, utilization review, or clinical documentation support.
Regulatory Compliance: Solid understanding of CMS guidelines, OASIS documentation, F2F criteria, and medical necessity rules.
Communication: Exceptional written and spoken English communication skills, with a confident professional presence when communicating with internal stakeholders and US physician offices.
Technical Setup: Dedicated, private remote workspace with a high-speed primary internet connection and a reliable backup internet option. High commitment to data security and strict compliance with HIPAA privacy standards.
Job Details
Job Type: Part-Time (20 hours/week)
Location: Philippines (Fully Remote)
Schedule: [Specify your preferred hours here, e.g., U.S. EST/CST Daytime hours or flexible shift]
Target Salary Rate: $6.00 – $7.00 / hour (or locally positioned at ₱37,000 – ₱42,000 per month pro-rated for part-time)