Job Overview
We are seeking a detail-driven Quality Assurance Specialist to safeguard the quality, accuracy, and compliance of our clinical documentation. In this role, you will serve as a key part of our compliance infrastructure, reviewing client charts to ensure every record meets internal standards, funder requirements, and Florida AHCA regulations.
Responsibilities
Review clinical charts for completeness, accuracy, and compliance, including:
- TCM (Targeted Case Management) notes
- BIOs (Biopsychosocial assessments)
- MTPs (Master Treatment Plans)
- PSR (Psychosocial Rehabilitation) notes
- TPRs (Treatment Plan Reviews)
- Identify documentation deficiencies, missing signatures, and compliance gaps; track corrections through resolution
- Monitor timeliness standards for notes, assessments, and plan reviews
- Audit records against AHCA (Agency for Health Care Administration) requirements, Medicaid documentation standards, and funder regulations
- Prepare charts for internal and external audits (AHCA, Medicaid, accrediting bodies)
- Provide training and coaching to clinical staff on documentation standards and common errors
- Generate QA and compliance reports for leadership, including error trends and corrective action follow-up
- Stay current on changes to Florida behavioral health regulations and payer documentation requirements
Requirements
- Proven QA experience, ideally in outpatient mental health or behavioral health settings
- Working knowledge of AHCA compliance requirements and Florida Medicaid documentation standards
- Direct experience reviewing TCM notes, BIOs, MTPs, PSR notes, and TPRs
- Strong knowledge of medical necessity criteria and treatment plan requirements
- Exceptional attention to detail and organizational skills
- Proficiency with EHR/EMR systems and Microsoft Office
- Familiarity with CARF or Joint Commission accreditation standards
- CPRS, EHR reporting, or QA data-tracking experience
Join us as a Quality Assurance Specialist to make a meaningful impact on product excellence while advancing your career in a vibrant industry dedicated to innovation and safety!
Pay: $24.43 - $26.00 per hour
Expected hours: 24.0 – 32.0 per week
Work Location: In person
