Job Overview
We are seeking a dedicated and detail-oriented Quality Assurance Specialist in Mental Health to uphold the highest standards of care, compliance, and safety within mental health services. In this vital role, you will oversee the quality management processes, ensure adherence to regulatory requirements, and promote continuous improvement across clinical operations. Your expertise will help foster a safe, compliant environment that prioritizes patient well-being and organizational excellence. This position offers an exciting opportunity to make a meaningful impact on mental health care delivery through rigorous oversight and proactive quality initiatives.
Duties
- Review clinical documentation and treatment plans to ensure compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations and privacy standards.
- Conduct audits of mental health services to verify adherence
- Monitor coding accuracy by verifying CPT (Current Procedural Terminology), ICD-9, ICD-10, and ICD coding for billing and documentation precision.
- Evaluate clinical workflows and documentation for compliance with Medicare guidelines and other payer requirements.
- Develop, implement, and update quality assurance protocols to enhance service delivery and regulatory compliance management.
- Collaborate with clinical teams to identify areas for improvement, provide training on compliance issues, and support corrective action plans.
- Maintain comprehensive records of audits, incident reports, corrective actions, and compliance activities for ongoing review and accreditation purposes.
Requirements
- Proven experience in healthcare quality assurance within mental health or behavioral health settings.
- Strong knowledge of HIPAA regulations, ICD coding systems (ICD-9/ICD-10), CPT coding, Medicare policies, FDA regulations, and JCAHO accreditation standards.
- Excellent analytical skills with the ability to interpret complex clinical data and documentation accurately.
- Familiarity with compliance management tools and methodologies to support organizational adherence to federal, state, and local regulations.
- Exceptional attention to detail combined with proactive problem-solving abilities.
- Effective communication skills for training staff, preparing reports, and collaborating across multidisciplinary teams.
- Relevant certifications such as Certified Professional in Healthcare Quality (CPHQ) or equivalent are preferred. Join us in our mission to elevate mental health care through rigorous quality assurance practices! This role is essential in ensuring that our services meet the highest standards of safety, compliance, and excellence—making a real difference in the lives of those we serve.
Pay: $25.73 - $30.99 per hour
Work Location: In person
