Job Overview
We are seeking an experienced Hospice Quality Assurance and Compliance Specialist to join our team. Your approach will drive continuous improvement, uphold compliance with regulatory requirements, and foster a culture of excellence across documentation and quality control operations.
Duties
- Conduct routine clinical record reviews to ensure regulatory compliance
- Audit admissions, recertifications, CTIs, Plans of Care, HOPE assessments, and IDG documentation
- Identify documentation deficiencies and collaborate with clinical staff to ensure timely correction
- Lead and coordinate responses to ADRs, medical record requests, denials, and appeals
- Assist with survey readiness, quality improvement initiatives, and compliance education
- Monitor documentation trends and provide recommendations to reduce compliance risk
Requirements
- Proven experience in quality assurance within manufacturing environments,
- Minimum of 2 years of hospice QA/compliance experience preferred
- Strong knowledge of Medicare hospice Conditions of Participation and regulatory requirements
- Experience reviewing CTIs, Plans of Care, IDG documentation, HOPE submissions, visit notes, and clinical records
- Experience managing and responding to Additional Documentation Requests (ADRs), claim denials, audits, and appeals
- Experience preparing organizations for state surveys and accreditation reviews
- MatrixCare experience preferred
- Excellent organizational, analytical, and communication skills
- RN/LVN
We are looking for a detail-oriented professional with a strong understanding of hospice regulations, documentation standards, and audit processes who can help maintain the highest level of clinical and regulatory compliance.
Pay: $23.30 - $28.06 per hour
Experience:
- Hospice QA/Compliance: 2 years (Required)
Work Location: In person
