Quality Assurance Specialist

Location:

Mount Prospect, IL Job Type:

Full-Time Work Setting:

100% Onsite (Mandatory)

Industry:

Home Health Care Position Summary We are seeking an experienced and detail-oriented Quality Assurance Specialist to join our Home Health team in Mount Prospect, Illinois. This position plays a critical role in ensuring compliance with federal, state, and payer regulations while supporting the delivery of high-quality patient care. The ideal candidate will have a strong background in home health quality assurance, clinical documentation review, regulatory compliance, and significant experience managing Additional Documentation Requests (ADR) . This is a fully onsite position and requires daily collaboration with clinical, administrative, and leadership teams. Essential Responsibilities Review clinical documentation for completeness, accuracy, and regulatory compliance. Conduct routine audits of patient records, OASIS assessments, plans of care, visit notes, physician orders, and other clinical documentation. Manage and coordinate all aspects of Additional Documentation Requests (ADR) , including record retrieval, review, organization, submission, and follow-up. Monitor compliance with CMS, Medicare, Medicaid, accreditation, and state home health regulations. Identify documentation deficiencies and work collaboratively with clinicians to ensure timely corrections. Assist with preparation for payer audits, regulatory surveys, and accreditation reviews. Track quality metrics and compliance indicators and provide reports to leadership. Educate and support staff regarding documentation requirements, quality standards, and regulatory updates. Maintain confidentiality and security of patient records in accordance with HIPAA regulations. Participate in quality improvement initiatives and corrective action plans. Ensure timely submission and retention of documentation required for audits and reimbursement purposes. Required Qualifications Minimum of 2 years of Quality Assurance experience in Home Health, Hospice, or Healthcare Compliance . Demonstrated experience handling Additional Documentation Requests (ADR) and audit responses. Strong knowledge of Medicare home health regulations and documentation requirements. Experience reviewing clinical records for compliance and reimbursement purposes. Excellent organizational skills with strong attention to detail. Proficiency with Electronic Medical Record (EMR) systems and Microsoft Office applications. Strong written and verbal communication skills. Ability to manage multiple deadlines and priorities in a fast-paced environment. Preferred Qualifications Experience with OASIS review and home health quality measures. Knowledge of CMS Conditions of Participation (CoPs). Experience with Medicare audits, UPIC, RAC, SMRC, or other payer reviews. Clinical background (RN, LPN, Therapist, or related healthcare experience) preferred but not required. CHAP, ACHC, or Joint Commission compliance experience is a plus. What We Offer Competitive salary based on experience Paid time off and holidays Health, dental, and vision insurance Professional development opportunities Stable and growing healthcare organization Collaborative and supportive work environment

Pay:

$28.00 - $56.00 per hour

Benefits:

Paid time off

Work Location:

In person