Home Health QA Specialist

The role

You will complete assigned Home Health QA reviews against quotas using an AI enabled review environment. You will validate ICD-10-CM coding accuracy and confirm OASIS responses match clinical records and CMS guidance.

What you will do

• Complete assigned Home Health reviews against quota.
• Check ICD-10-CM accuracy, sequencing, specificity, and guideline compliance.
• Confirm OASIS responses are clinically supported and match CMS guidance.
• Focus on items that move outcomes such as GG items, functional status, and medication management.
• Flag incomplete, unsigned, unclear, or contradictory documentation.
• Review AI-generated coding, OASIS, and documentation suggestions.
• Report recurring errors or workflow gaps to improve AI training data.
• Maintain HIPAA compliance and confidentiality.
• Maintain quality scores and participate in training and calibration sessions.

Required qualifications

• Real home health chart review experience
• Active or in-progress OASIS certification (HCS-O, COS-C, or another Nestmed-approved credential)
• A current, applicable ICD-10-CM coding credential, HCS-D, BCHH-C, CPC, RHIT
• Comfort working inside an AI-assisted workflow
• Writing tight enough that a QA comment does not need a follow-up conversation
• Discipline to escalate instead of guess when a chart does not clearly support an answer

Nice to have

• in-progress OASIS certification

Before you apply

• Knowledge check quiz/assignment
• Call with our Recruiter
• Final Round with Hiring Manager!

About the company

Nestmed is building the AI-native operating system for post-acute care. 7 of the 10 largest home health companies in the US already run on Nestmed.