Medical QA/Coder/Biller/Back-up Lead

Medical Quality Assurance (QA) Specialist / Coder / Biller / Back-up Lead

Is Tender for you?

Are you looking for a challenging position in the medical field? If you are interested in getting acclimated into the medical industry by reviewing detailed clinical records then apply to Tender Home Health.

If you are interested in a competitive salary, medical benefits, bonuses and career growth, apply now. Tender Home Health is a young, energetic company that values the growth of each of our team members. The Medical Quality Assurance (QA) / Coder will ensure accuracy and compliance of clinical documentation by reviewing, auditing, and coding Home Health records per regulatory standards.

QualificationsRequired:

• Active RN, LVN/LPN, or certified medical coder (e.g., CPC, CCS, HCS-D) credential
• Minimum 1 year experience in Home Health Quality Assurance
• Minimum 1 year of experience in Home Health coding (ICD-10, OASIS)
• At least 1 year experience maximizing revenue on a per-claim basis through proper coding, episode analysis, and reimbursement optimization
• At least 1 year experience helping a Home Health agency achieve and/or maintain a 5-star rating through quality reviews, compliance updates, and performance improvement initiatives
• At least 1 year of management or leadership experience
• Strong knowledge of Medicare guidelines, PDGM, and regulatory compliance
• Proficient with computers and applications: Microsoft Office Suite, Google Workspace, etc.
• Tech-savvy with the ability to quickly learn Electronic Medical Record (EMR/EHR) systems
• Demonstrates a growth mindset, personal accountability, and initiative in achieving goals
• Ability to train and educate clinical staff on coding best practices

Desired:

• HCS-D or BCHH-C certification (Home Health-specific coding credentials)
• Experience with WellSky, Homecare Homebase, or similar EHRs
• Background in Quality Assurance, Utilization Review, or Compliance
• Knows how AI tools work and how to use them efficiently

Your Day-to-Day Activities

QA Specialist will review medical records to ensure they are complete and accurate. To achieve this, QA must be detail-oriented and work closely with the clinical staff.

Specific activities include:

• Review and code Home Health patient records, ensuring accuracy and compliance with ICD-10, OASIS, and PDGM guidelines
• Conduct reimbursement optimization reviews to ensure accurate coding of primary and comorbid conditions that impact case mix weight and PDGM payment calculation
• Audit clinical documentation for completeness, proper diagnosis coding, and alignment with Medicare and regulatory standards
• Collaborate with clinicians to clarify documentation and provide guidance on proper coding practices
• Identify and correct coding errors, inconsistencies, or missing information in patient records
• Educate and train nurses, therapists, and other clinical staff on best practices for coding and documentation
• Monitor regulatory updates and ensure the agency remains compliant with Medicare, Medicaid, and payer requirements
• Work with QA and compliance teams to improve documentation accuracy and reimbursement optimization
• Utilize EHR systems (e.g., WellSky, Homecare Homebase) to review, document, and update patient records
• Assist in pre-bill audits to reduce denials and optimize revenue cycle performance

Pay: From $850.00 per month

Benefits:

• Paid time off

Application Question(s):

• Do you have minimum 1 year of experience in Home Health coding (ICD-10, OASIS)?
• Do you have at least 1 year experience maximizing revenue on a per-claim basis through proper coding, episode analysis, and reimbursement optimization?
• Do you have at least 1 year experience helping a Home Health agency achieve and/or maintain a 5-star rating through quality reviews, compliance updates, and performance improvement initiatives
• Do you have at least 1 year of management or leadership experience?
• Are you willing to work 40hrs per week? 8hrs daily (plus 1hr lunch in between), following PST.

Experience:

• Home Health Quality Assurance: 1 year (Required)

License/Certification:

• Nursing License (Required)
• certifications with coding and leadearship? (Required)

Work Location: Remote