RN Medical QA
Job description:
OASIS RN QA- Department: Clinical Quality / OASIS QA
- Employment Type: Full-time
- Location: Parañaque City - On-site.
- Reports to: Clinical Supervisor/Nursing Supervisor
Job Overview
The OASIS QA Registered Nurse is responsible for reviewing and ensuring the accuracy, completeness, and compliance of OASIS-E1 documentation and associated clinical visit narratives completed by field clinicians.
This role supports regulatory compliance, payer requirements, and internal documentation standards through structured chart review, ICD-10 coding validation, and real-time monitoring of visit documentation for active patients.
This is a non-bedside, quality assurance role focused on documentation governance, clinical accuracy, and risk mitigation.
Key Responsibilities- Review OASIS-E1 Start of Care (SOC) and Resumption of Care (ROC) documentation for completeness, accuracy, and compliance
- Validate and correct ICD-10 diagnosis coding based on referral documentation,MD orders, and clinical records
- Ensure all visit documentation includes required clinical elements:wound status update (with photo if applicable)
- vital signs, visit events, medication reconciliation, general health assessment (pain, cardiovascular, neurological, GI/GU,integumentary), skilled interventions performed, patient/caregiver education, EVV / visit verification
- Review and complete clinical narratives for assigned SOC and ROC charts
- Monitor active patient charts in Axxess in real time to ensure visit documentation is complete and compliant
- Identify documentation gaps and return charts for correction with clear QA feedback
- Flag and escalate critical documentation errors that may affect compliance or reimbursement
- Collaborate with Clinical Operations, Intake, Billing, and QA teams to ensure documentation readiness for billing
Scope of Review
Included:
- OASIS-E1 Start of Care (SOC)
- OASIS-E1 Resumption of Care (ROC) (within 7 days of facility discharge)
Excluded:
- Recertifications
- Discharges
- Routine non-OASIS visits (except for visit documentation QA monitoring)
- QA reviews are based on all active patients within Axxess, not assigned patient panels
- Workload is dependent on daily visit frequency and census
- Clinical narratives must be completed within 48 hours of submission
- Visit documentation QA monitoring is expected in real-time / same-day review visibility
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:
- o Medical-Surgical
- o Emergency Room
- o Operating Room
- o Orthopedics
- General Surgery
- o Stepdown / ICU
- Minimum 1.5 years experience in at least one of the following:
- OASIS documentation review
- ICD-10 coding (home health or post-acute)
- Clinical documentation QA / audit
- Strong clinical documentation and chart review skills
- ICD-10 coding familiarity and validation skills
- EMR/EHR proficiency (Axxess experience preferred)
- Strong understanding of medical necessity and skilled documentation
- Strong written communication and structured clinical writing
- Ability to provide clear, constructive QA feedback
- Home health or post-acute care experience
- Medicare / Medi-Cal documentation standards knowledge
- No direct patient care
- No case management assignment
- No clinician supervision responsibilities
Acceptable Experience Combinations
The following ratios are acceptable:
- 1:1.5 (Bedside: QA/Coding/OASIS)
- 1.5:1.5
- 2:1.5 or higher
Candidates with less than 1 year bedside experience, or less than 1.5 years QA/coding/OASIS experience will not be considered.