Home Health Quality Assurance (QA)

Home Health Quality Assurance (QA) Americade Home Health Agency Westminster, CA Job Details Full-time $25 - $28 an hour 1 hour ago Benefits 401(k) Paid time off Qualifications TJC Medicare Medical law CMS CMS regulatory compliance Medicare regulations Healthcare privacy protection Project management experience in healthcare Clinical documentation Continuous clinical improvement initiatives Health information regulatory compliance Centers for Medicare & Medicaid Services (CMS) billing regulations Medicaid regulations Medicaid Home health Home healthcare regulations Health information management Quality audits Clinical documentation standards Home health agency experience Medical terminology Hospital experience Quality assurance experience within healthcare Full Job Description Job Summary We are seeking a dedicated and detail-oriented Home Health Quality Assurance (QA) to ensure the highest standards of care and compliance within our home health agency. In this vital role, you will oversee quality assurance processes, monitor adherence to healthcare regulations, and support continuous improvement initiatives. Your expertise will help maintain compliance with federal, state, and local healthcare policies, including CMS regulations, HIPAA privacy standards, and The Joint Commission accreditation requirements. This position offers an exciting opportunity to impact patient safety and service excellence in a dynamic healthcare environment. Responsibilities Conduct comprehensive audits of electronic health records using Data Soft Logic (DSL) to verify accuracy, completeness, and compliance with Medicare and managed care policies. Review clinical documentation for adherence to medical terminology standards, CPT coding, ICD-9/ICD-10 coding accuracy, and proper billing practices. Ensure compliance with HIPAA privacy and security regulations during all data handling activities. Monitor clinical workflows to confirm alignment with DHS regulations and healthcare law requirements. Collaborate with clinical staff to identify areas for quality improvement based on audit findings and regulatory updates. Maintain detailed records of audits, corrective actions, and compliance reports in accordance with The Joint Commission standards. Stay current on CMS regulatory changes and health regulation policies to inform ongoing quality assurance strategies. Requirements Strong understanding of HIPAA privacy rules and security standards for protected health information (PHI). Proficiency in CPT coding, ICD-9/ICD-10 coding systems, and medical terminology. Knowledge of CMS regulations related to Medicare and Medicaid home health services. Experience with DSL system for documentation review and data analysis (PREFERRED). Familiarity with The Joint Commission regulations impacting healthcare documentation and medication management. Ability to interpret healthcare laws such as the Medical Law Act and manage compliance with health regulation policies. Project management skills within a healthcare setting to coordinate audits, training sessions, and quality improvement initiatives. 3+ years previous home health QA experience (REQUIRED) Experience with developing, implementing, and evaluating quality management programs and activities in a home health setting Excellent verbal and written communication skills required Join us in our mission to elevate home health care through rigorous quality assurance practices! We are committed to fostering a supportive environment that values your expertise in healthcare compliance, regulation management, and continuous improvement efforts. This role is essential in ensuring our services meet the highest standards of safety, efficiency, and patient-centered care.

Pay:

$25.00 - $28.00 per hour

Benefits:

401(k) Paid time off Application Question(s): Do you have previous quality assurance experience?

Work Location:

In person