Clinical Quality Specialist

Position: Clinical Quality Assurance Specialist
Department: Behavioral Health – Substance Use & Mental Health Services
Location: Remote
Employment Type: Full-Time
Reports To: Executive Team

About Us:
Remedy Medical Billing provides treatment facilities with an ethical billing partner who could provide dependable results, transparent services, and individualized attention at an affordable cost. We are a partner when it comes to working with facilities in order to help provide care to more patients.

Position Summary:
The Clinical Quality Assurance (QA) Specialist ensures compliance with internal clinical documentation standards, payer requirements, and regulatory guidelines (e.g., JCAHO, CARF, state licensing, Commercial Insurance, Medicaid/Medicare). This position supports continuous quality improvement by conducting audits, reviewing clinical documentation, and identifying training opportunities for clinical staff. The ideal candidate has strong knowledge of substance use and mental health treatment modalities and demonstrates an eye for detail, excellent communication skills, and a passion for improving care delivery.

Key Responsibilities:

• Conduct regular audits of clinical records for completeness, accuracy, timeliness, and compliance with all regulatory and accreditation standards.
• Monitor and ensure adherence to clinical documentation standards, including treatment plans, assessments, progress notes, and discharge summaries.
• Identify trends or deficiencies in clinical documentation and collaborate with leadership to implement corrective actions.
• Provide feedback, training, and technical assistance to clinical staff regarding documentation best practices and quality standards.
• Support readiness for internal and external audits or reviews (e.g., accreditation surveys, state inspections).
• Assist in developing QA tools, workflows, and performance indicators aligned with clinical and operational goals.
• Collaborate with compliance, UR, and clinical leadership teams to promote a culture of continuous improvement and accountability.

Qualifications:

• Master’s degree in Social Work, Counseling, Psychology, Nursing, or related behavioral health field (preferred).
• Licensed or license-eligible (LCSW, LMFT, LPC, etc.) preferred.
• Minimum 2–3 years of experience in behavioral health settings, preferably including quality assurance or clinical supervision.
• Strong knowledge of documentation standards, ASAM Criteria, DSM-5/ICD-10, and state/federal regulations.
• Familiarity with electronic health records (EHRs) and documentation workflows.
• Excellent analytical, organizational, and written communication skills.
• Ability to manage multiple priorities and work collaboratively in a team-based environment.

Preferred Experience:

• Experience working in substance abuse treatment programs (detox, residential, PHP, IOP, outpatient).
• Knowledge of payer documentation requirements (commercial, Medicaid, Medicare).
• Familiarity with accreditation standards (JCAHO, CARF).
• Familiarity with commercial, Medicaid and medicare insurance

What We Offer:

• Competitive salary and benefits package
• Opportunities for professional growth and development
• Supportive and mission-driven work culture

Job Type: Full-time

Pay: $50,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance
• Work from home

Work Location: Remote