OASIS & POC REVIEWER- HOME HEALTH (US-BASED APPLICANTS)

OASIS \& POC ReviewerPosition Overview We are seeking an experienced **OASIS \& POC Reviewer** to join our home health team. This position is responsible for reviewing **OASIS assessments and Plans of Care (POCs)** to ensure clinical accuracy, completeness, consistency, medical necessity, and compliance with **CMS and Medicare home health requirements**. The ideal candidate will have strong **U.S. home health clinical experience**, excellent knowledge of OASIS and Medicare requirements, and the ability to identify documentation, coding, and compliance concerns. This role requires strong clinical judgment, attention to detail, and the ability to provide clear and actionable feedback to clinicians and agency teams. Key Responsibilities * Review **OASIS assessments and Plans of Care (POCs)** for accuracy, completeness, clinical consistency, and regulatory compliance. * Validate that diagnoses, clinical findings, goals, interventions, physician orders, and visit frequencies are appropriately supported by the patient's medical record and plan of care. * Identify documentation gaps, inconsistencies, discrepancies, and potential **medical necessity, compliance, or reimbursement concerns**. * Review documentation for alignment with **CMS, Medicare, OASIS, and U.S. home health regulatory requirements**. * Identify potential OASIS inaccuracies or documentation issues that may affect patient care, compliance, reimbursement, or claims. * Provide timely, clear, and actionable feedback to clinicians and home health agency teams. * Collaborate with **Coding, QA, Clinical, and Operations teams** to resolve documentation and coding concerns. * Monitor recurring documentation and OASIS issues and assist with identifying opportunities for quality improvement. * Stay current with changes to **CMS regulations, Medicare home health requirements, OASIS guidance, and Plan of Care standards**. * Complete reviews accurately and within established productivity and turnaround\-time expectations. Required Qualifications * **Active, unrestricted Florida Registered Nurse (RN) license – REQUIRED.** * **Current Home Health Coding Certification – REQUIRED.** * Minimum **2–3 years of U.S. home health nursing experience**. * Demonstrated experience with **OASIS assessments and Plan of Care (POC) review**. * Strong knowledge of **Medicare\-certified home health operations and documentation requirements**. * Strong understanding of **CMS regulations and Medicare home health guidelines**. * Knowledge of home health coding, diagnosis coding, and documentation requirements. * Ability to assess clinical documentation for **accuracy, completeness, consistency, and medical necessity**. * Strong clinical judgment and analytical skills. * Excellent written and verbal communication skills. * Strong attention to detail and ability to identify documentation discrepancies and compliance risks. * Experience working with **U.S. home health EMR/documentation systems**. Preferred Qualifications * Previous experience as a **Home Health QA Reviewer, OASIS Reviewer, Clinical Documentation Reviewer, Clinical Manager, Coding QA Specialist, or Utilization Review Nurse**. * OASIS certification or formal OASIS review training. * Experience reviewing **Start of Care (SOC), Resumption of Care (ROC), Recertification, and Transfer/Discharge OASIS assessments**. * Experience reviewing Plans of Care for Medicare\-certified home health agencies. * Experience collaborating with home health clinicians, coders, QA teams, and operations leadership. * Strong understanding of **PDGM, Medicare home health billing, clinical documentation, and medical necessity**. * Familiarity with current OASIS and CMS guidance. Mandatory Requirements To be considered for this position, applicants **must meet all of the following requirements**: * **Active Florida RN license** * **Home Health Coding Certification** * **U.S. home health nursing experience** * **Hands\-on OASIS review experience or strong working knowledge of OASIS** * **Strong knowledge of Medicare/CMS home health requirements** * **Experience reviewing Home Health Plans of Care (POCs)** **Please note:** Applicants who do not hold an active Florida RN license and a current Home Health Coding Certification will not be considered for this position. Ideal Candidate The ideal candidate is a **Florida\-licensed RN with strong U.S. home health experience** who understands the relationship between clinical documentation, OASIS accuracy, coding, medical necessity, and Medicare compliance. The candidate should be comfortable reviewing documentation independently, identifying potential issues, and communicating recommendations professionally to clinical and operational teams. You may send your resume to uscareers@cliniqon.com Benefits: * Paid time off Application Question(s): * Are you able to start ASAP? * Do you have home health coding license or certifications? Experience: * POC : 1 year (Required) * OASIS: 1 year (Required) * Home Health Coding: 1 year (Required) Work Location: Remote