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Claim Health

AI-powered post-acute billing optimization

Clinical Quality Assurance Nurse

Manual & Functional QAConfirmed live in the last 24 hours
Full-timeNew York, NY, USANo salary listedIn-person

About the Job

Requirements

  • An active Registered Nurse license is required; a New York or compact license is preferred.
  • At least 3 years of home health and/or hospice clinical experience is required.
  • Strong understanding of OASIS documentation and home health eligibility requirements is required.
  • Experience reviewing physician orders, certifications, plans of care, face-to-face documentation, and hospice election paperwork is required.
  • Hands-on experience with HomeCare HomeBase, Axxess, and WellSky is required; KanTime is a plus.
  • Strong understanding of Medicare home health and hospice documentation requirements is required.
  • Experience writing standard operating procedures, quality assurance guidelines, or training documentation is required.
  • Strong attention to detail and pattern recognition are required.
  • Comfort working in a fast-paced startup environment is required.

Responsibilities

  • Review charts processed by the clinical automation platform for accuracy, completeness, and consistency; validate whether documentation supports services, identify incorrect classifications, and investigate automation errors.
  • Partner with engineering and product teams to refine how artificial intelligence evaluates clinical documentation; identify missed clinical nuances, recommend decision rules, and validate improvements before deployment.
  • Develop standard operating procedures defining how clinical documentation should be reviewed across home health and hospice, standardizing 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, and help configure automations to align with client processes.
  • Measure and improve documentation quality, automation accuracy, exception rates, clinical escalations, and rework, while identifying opportunities to improve automation performance.

Desired Qualifications

  • QA, Clinical Documentation Integrity, or compliance experience.
  • Experience with artificial intelligence, workflow automation, or healthcare technology companies.
  • Familiarity with referral platforms including Careport and Forcura.
  • Experience implementing or optimizing electronic medical record workflows.

About the Company

Claim Health

AI-powered post-acute billing optimization

Claim Health provides an AI-powered platform for post-acute care revenue cycle management that helps healthcare agencies reclaim revenue and reduce claim denials. The product uses an AI rules engine to create and submit compliant claims quickly, backed by 24/7 expert support and a compliance engine. It differentiates itself by specializing in post-acute care, delivering a high first-pass acceptance rate and analytics-driven insights to identify improvement opportunities. The company aims to shrink denials, improve overall financial performance, and allow providers to devote more time to patient care.

Company size
11-50
Company stage
Seed
Total funding
$4.5M
Headquarters
New York City, New York
Founded
2025

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