Overview
Clinical Reviewer Jobs in Dhaka, Dhaka, Bangladesh at UMR Labs
Title: Clinical Reviewer
Company: UMR Labs
Location: Dhaka, Dhaka, Bangladesh
Clinical Quality Assurance Reviewer
Candidates who are experienced Home Health QA/OASIS reviewers with strong clinical documentation review experience to qualify for the role.
Position Summary
The Clinical Quality Assurance Reviewer is responsible for reviewing home health clinical documentation before it progresses to the billing process. This role focuses on ensuring OASIS accuracy, plan of care completeness, regulatory compliance, and documentation integrity. The reviewer verifies that records adequately support skilled need and homebound status in accordance with Medicare guidelines.
This is a non-patient-facing role. All communication is conducted internally with clinicians, therapists, and clinical leadership teams. The position is focused on documentation quality, compliance, and audit readiness rather than direct patient care.
Key Responsibilities
- Review Start of Care (SOC), Resumption of Care (ROC), Recertification, Transfer, and Discharge documentation within the agency’s EMR system.
- Validate OASIS responses for consistency with clinical visit notes, medication profiles, therapy documentation, and functional assessment records.
- Verify that homebound status and skilled need documentation are patient-specific and compliant with Medicare requirements.
- Ensure plans of care align with assessment findings, including disciplines, visit frequencies, goals, interventions, and physician orders.
- Track and follow up on missing physician orders, certifications, signatures, and required documentation.
- Identify documentation deficiencies that may create risks during payer audits, ADR reviews, or regulatory surveys.
- Return charts to clinicians with clear and actionable correction recommendations.
- Maintain documentation review logs and provide daily productivity and quality reports.
- Escalate recurring documentation issues and compliance trends to leadership.
- Meet established chart review productivity and turnaround-time expectations.
Required Qualifications
- Minimum 2–3 years of experience reviewing U.S. Home Health documentation.
- Active Registered Nurse (RN) or Physical Therapist (PT) license in the country of residence (U.S. licensure not required).
- Strong understanding of Medicare Home Health Conditions of Participation (42 CFR Part 484).
- Working knowledge of Medicare Home Health coverage guidelines and documentation requirements.
- Experience with OASIS assessments, including all assessment time points.
- Understanding of PDGM and the impact of OASIS documentation on reimbursement.
- Hands-on experience with WellSky Home Health.
- Experience reviewing nursing and/or therapy documentation, including assessments, care plans, goals, interventions, and clinical compliance requirements.
- Ability to evaluate documentation supporting skilled need, homebound status, functional outcomes, and patient progress.
- Strong written English communication skills for providing clear documentation feedback.
- Ability to work Pacific Time (PST) business hours from an offshore delivery center.
Preferred Qualifications
- Candidates with both nursing and therapy documentation review experience are highly preferred.
- Experience supporting U.S. Home Health agencies.
- Familiarity with Home Health Value-Based Purchasing (HHVBP) and Home Health Quality Reporting Program (HH QRP) measures.
- Exposure to ICD-10-CM diagnosis selection and documentation requirements.
- Experience supporting audit preparation, ADR responses, or regulatory surveys.
- Knowledge of Occupational Therapy (OT) and Speech Therapy (ST) documentation review.
- Strong analytical, compliance, and quality assurance skills.
Work Schedule
- Full-time dedicated position.
- Must be available during Pacific Time (PST) business hours.
If you are interested, please send your cv to [email protected]
