Quality Compliance Specialist

Position Summary

The Quality Compliance Specialist supports clinical quality, documentation accuracy, and regulatory compliance within a psychiatry and behavioral health practice. This role focuses on monitoring patient engagement, auditing clinical documentation, supporting prior authorization processes, and ensuring compliance with payer, regulatory, and internal standards. The specialist works closely with psychiatric providers, clinical leadership, and administrative teams to support high-quality, compliant patient care.

Key Responsibilities

Patient Records & Care Coordination

• Connect with patients requiring completion of new or updated intake and clinical paperwork


• Connect with patients not seen within the past three months for scheduling


• Prepare and manage patient discharge letters in accordance with behavioral health policies and continuity-of-care requirements


• Coordinate with providers and administrative staff to resolve missing or incomplete documentation


• Support the Prior Authorizations team and process Prior Authorizations as needed

Clinical Documentation Audit & Compliance

• Conduct regular provider note compliance checks


• Audit patient charts for completeness

Quality & Process Improvement

• Assist in developing and maintaining audit tools, compliance workflows, and documentation 


• Support quality improvement initiatives related to patient access, retention, and documentation compliance


• Maintain strict confidentiality and compliance with HIPAA and organizational policies

Qualifications

• A minimum of an associates degree 


• Experience in behavioral health, psychiatry, healthcare administration, compliance, or medical records


• Strong attention to detail and ability to manage sensitive clinical information


• Proficiency with electronic health records (EHR) and standard office software

Preferred

• Associate’s or Bachelor’s degree in Healthcare Administration, Psychology, Health Information Management, or related field


• Familiarity with behavioral health documentation standards, audits, and prior authorization processes


• Knowledge of HIPAA and behavioral health confidentiality regulations

Skills & Competencies

• Strong analytical and organizational skills


• Clear and professional written and verbal communication


• Ability to collaborate effectively with psychiatric providers and clinical teams


• Discretion and sound judgment when handling confidential behavioral health information


• Experience in completing Prior Authorizations for medications


• Strong skills in general computerized tasks, including excel with data manipulation, word, google, etc. 

Work Schedule

• Full-time, hourly position


• Standard business hours (specific schedule to be determined)


• Location: hybrid