RN QA Specialist- Home Health

Are you looking to make a difference in patients’ lives with a company that values your expertise?
Join us in our mission to deliver compassionate, high-quality healthcare where it matters most—at home.

Pinnacle Home Care, Florida’s largest independent Medicare-certified home health provider, has delivered exceptional, patient-centered care for more than two decades. We are seeking a Quality Assurance Specialist - Registered Nurse to join our award-winning team.

Qualifications

• Current, active Registered Nurse (RN) license.
• Nationally accredited ICD-10 coding certification, maintained annually (e.g., HCS-D ).
• Nationally accredited OASIS certification, maintained annually (e.g., HCS-O or COS-C ).
• Formal clinical background.
• Minimum of three (3) years of ongoing ICD-10-CM coding and abstracting experience in a home health setting (preferred).
• Proficiency with PCs, web-based portals, database software, and Microsoft Office Suite (Access, Excel, Outlook, PowerPoint, and Word).
• Home health experience preferred.
• OASIS analysis experience preferred.
• Working knowledge of SHP and/or Decision Health Coding Pro preferred.

Why Choose Pinnacle?

Growth & Stability:

• Over 20 years as Florida’s largest independent home health agency.

Professional Development:

• Complimentary Continuing Education Units (CEUs) to support licensure and career growth.

Competitive Benefits & Perks:

• Includes an employee referral program with reward opportunities.

Recognized Excellence:

• Proudly ranked as a USA Today Top Workplace .

Supportive, Engaging Culture:

• Join a collaborative, forward-thinking team that values professional excellence and personal fulfillment.

Key Responsibilities:

• Perform centralized coding using scanned medical records and clinician documentation within the EMR.
• Provide comprehensive home health coding, OASIS, Plan of Care (POC), and quality reviews.
• Make independent determinations regarding accurate ICD-10-CM coding, OASIS data, POC accuracy, and quality assignments.
• Review medical records and recommend changes for clinician review and acceptance in accordance with CMS regulations, industry standards, and coding conventions, as supported by documentation.
• Review Plans of Care for accuracy and quality, and provide recommendations for improvement.
• Apply expert knowledge of medical terminology, disease processes, and pharmacology.
• Assess and review clinical assessments for coding accuracy, OASIS compliance, CMS regulations, coding conventions, and overall Plan of Care quality.
• Code all assessments using ICD-10-CM (SHP and Decision Health Coding Pro software) and appropriate industry references.
• Collaborate with the Team Lead and/or Director of Quality & Clinical Outcomes to resolve complex coding issues.
• Participate in ongoing education related to ICD-10 coding, OASIS, quality standards, and Plan of Care development; monitor regulatory changes and communicate updates to leadership.
• Meet or exceed auditing and productivity benchmarks, maintaining a minimum quality score of 93% on monthly and/or quarterly audits.
• Plan, prioritize, and organize work effectively to meet established objectives and deadlines.
• Ensure efficient and appropriate use of company resources, including equipment and services.
• Assist with special projects and perform additional duties as assigned.
• Adhere to all federal, state, and agency regulations, maintaining strict confidentiality of patient and agency information in compliance with HIPAA requirements.
• Follow the Code of Conduct and submit all documentation in a timely manner per agency policy.
• Attend required in-service training and educational programs.

Pinnacle Home Care is an equal opportunity employer committed to fostering an inclusive environment. We prohibit discrimination or harassment based on race, religion, age, gender, national origin, disability, veteran status, or any other legally protected characteristic.

Only candidates whose qualifications closely align with the requirements of this role will be contacted.

Be part of a company that empowers clinicians to make a meaningful difference in the lives of more than 10,000 patients across Florida every day.
Apply today!

#BetterTeam

About Pinnacle Home Care Inc.:

Pinnacle has 16 locations throughout Florida hiring for Healthcare Sales Professionals, Clinical Managers, RNs, LPNs, PTs, PTAs, SLPs, OTs, OTAs and other Healthcare positions. If you don't see a role that meets your skill set on the job board, send us your resume directly to [email protected] Please include your full name and location! We look forward to assisting you in exploring career opportunities with Pinnacle Home Care! About Us: Pinnacle Home Care, the largest independent home healthcare provider in Florida, has proudly served our communities for over two decades. We are a team driven by a passion for home healthcare with an unwavering commitment to the well-being of our patients and their families. At Pinnacle, we foster a forward-thinking, collaborative workplace culture. This has earned us multiple recognitions including the Top Workplaces USA award – a testament to our focus on supporting and empowering our employees. We offer a comprehensive suite of services, including skilled nursing, physical therapy, occupational therapy, speech therapy, medical social work and home health aide support to more than 10,000 patients across our service areas. We strive to help seniors thrive, not only under our care, but long after our services are complete. At Pinnacle, we are proud to make a meaningful difference in the lives of patients and their families every day. Join us in our mission to deliver compassionate healthcare where it matters most – at home.