New York, New York, United States · On-site
About the Role We're hiring a Registered Nurse with deep home health and hospice experience to own the clinical quality of the documentation flowing through our AI platform. Our automations review referrals, OASIS docume…
Skills: Clinical Quality Assurance, OASIS Documentation, Home Health Care, Hospice Care, Clinical Auditing
New York, New York, United States · On-site
About the Role We're hiring an experienced Prior Authorization Specialist to help build the future of authorization automation for home health and hospice. Prior authorization is one of the largest operational bottleneck…
Skills: Prior Authorization, Workflow Auditing, SOP Development, Payer Portal Management, Eligibility Verification
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The role involves auditing clinical documentation processed by an AI platform to ensure accuracy and consistency in home health and hospice settings. The nurse will partner with engineering teams to refine AI logic and develop standardized clinical review SOPs.
Requires an active RN license and at least 3 years of clinical experience in home health or hospice, with deep knowledge of OASIS and Medicare requirements. Proficiency with EMRs like HomeCare HomeBase, Axxess, and WellSky is essential.
We're hiring a Registered Nurse with deep home health and hospice experience to own the clinical quality of the documentation flowing through our AI platform.
Our automations review referrals, OASIS documentation, certifications, physician orders, hospice election forms, face-to-face documentation, and supporting clinical records before they reach billing and authorization workflows. Your job is to ensure those automations make clinically sound decisions, identify where they fail, and continuously improve their accuracy.
You'll work at the intersection of clinical expertise, quality assurance, and AI. Rather than reviewing a handful of patient charts each day, you'll help build systems that review thousands correctly.
This is not a bedside or utilization review position. It's an operations and quality role for a nurse who enjoys finding edge cases, improving processes, and translating clinical judgment into scalable automation.
Review charts processed by our clinical automation platform for accuracy, completeness, and consistency. Validate whether documentation supports services, identify incorrect classifications, and investigate why automation errors occurred.
Partner with engineering and product teams to refine how our AI evaluates clinical documentation. You'll identify where automations miss important clinical nuances, recommend decision rules, and validate improvements before they're deployed.
Develop SOPs that define how clinical documentation should be reviewed across home health and hospice. Standardize quality expectations while accounting for agency-specific workflows and payer requirements.
Work directly with agencies to understand their documentation standards, clinical workflows, and compliance expectations. Help configure automations that align with each client's operational processes.
Measure and improve documentation quality, automation accuracy, exception rates, clinical escalations, and rework. Continuously identify opportunities to improve automation performance.
Active RN license (NY or compact license preferred)
3+ years of home health and/or hospice clinical experience
Strong understanding of OASIS documentation and home health eligibility requirements
Experience reviewing physician orders, certifications, plans of care, face-to-face documentation, and hospice election paperwork
Hands-on experience with HomeCare HomeBase (HCHB), Axxess, and WellSky; KanTime a plus
Strong understanding of Medicare home health and hospice documentation requirements
Experience writing SOPs, QA guidelines, or training documentation
Excellent attention to detail and pattern recognition
Comfortable working in a fast-paced startup environment
QA, Clinical Documentation Integrity (CDI), or Compliance experience
Experience with AI, workflow automation, or healthcare technology companies
Familiarity with referral platforms including Careport and Forcura
Experience implementing or optimizing EMR workflows
Scale your clinical expertise. Help AI review thousands of charts instead of reviewing them one at a time.
Own quality. Your feedback directly improves the clinical accuracy of our platform across every customer.
Influence the product. Work side-by-side with engineering to shape how AI understands home health and hospice documentation.
AI Revenue Platform for Post-Acute Care
Post-acute care loses billions to broken revenue infrastructure. Claim Health prevents it. We catch denials before they happen, automate the work drowning ops teams, and connect every step from referral to cash so agencies can scale without adding headcount.
View all jobs at Claim HealthAI Revenue Platform for Post-Acute Care
Post-acute care loses billions to broken revenue infrastructure. Claim Health prevents it. We catch denials before they happen, automate the work drowning ops teams, and connect every step from referral to cash so agencies can scale without adding headcount.
View all jobs at Claim Health