Home Health Clinical Quality Assurance and Authorization Specialist (Remote) at a United States-based Home-health Agency | United States (Remote)
Company/Recruiter: a United States-based Home-health Agency
Published on: 10:26 PM | Aug 25, 2026
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✦ AI Summary
Join a leading United States-based home-health agency dedicated to providing exceptional patient care in the comfort of their homes.
Join a leading United States-based home-health agency dedicated to providing exceptional patient care in the comfort of their homes. We are currently seeking a motivated and detail-oriented Remote Home Health Clinical Quality Assurance and Authorization Specialist to join our growing team. This vital role ensures the highest standards of clinical quality and efficient authorization processes, contributing directly to positive patient outcomes and operational excellence.
Job Overview
The Home Health Clinical Quality Assurance and Authorization Specialist will be instrumental in upholding our commitment to quality care through rigorous review and authorization processes. This remote position offers the opportunity to contribute significantly to our mission while enjoying the flexibility of working from home.Key Responsibilities
- Conduct comprehensive clinical chart reviews to ensure compliance with agency policies, state, and federal regulations.
- Verify accuracy and completeness of patient documentation, treatment plans, and progress notes.
- Manage and process prior authorization requests with payers, ensuring timely and accurate submissions.
- Communicate effectively with clinical staff, physicians, and insurance providers regarding authorization status and requirements.
- Identify trends and areas for improvement in clinical documentation and authorization processes.
- Participate in quality improvement initiatives and provide feedback to clinical teams.
Requirements
- Registered Nurse (RN) or Licensed Physical Therapist (PT) in good standing.
- Valid professional qualification or license as a Registered Nurse or Physical Therapist.
- Minimum of three years of experience in home healthcare.
- Experience with Kinnser/WellSky Home Health software is highly preferred.
- Strong understanding of home health regulations and payer authorization processes.
- Excellent analytical, organizational, and communication skills.
- Ability to work independently and manage time effectively in a remote setting.
What We Offer
- Opportunity to work remotely for a reputable home-health agency.
- Be part of a dedicated team committed to high-quality patient care.
- Professional development and growth opportunities within the organization.
- A supportive and collaborative work environment.