Overview
Eligibility Specialist III (Medicaid QA/Training) Jobs in Winston-Salem, NC at Forsyth County
Are you a detail-driven leader with a passion for healthcare compliance, quality assurance, and operational excellence? Do you thrive in a fast-paced environment, ensuring accuracy, efficiency, and top-tier service? If so, we want YOU to join our team as a Coding & Quality Assurance Manager for Home Health & Hospice!
Location: United States (Remote)
Competitive Salary + Benefits + Career Growth!
Why Join Us?
Impactful Work – Play a crucial role in maintaining excellence in Home Health & Hospice care
Innovative Culture – Work in a supportive, forward-thinking environment where your expertise is valued
Career Growth – Expand your skills and lead initiatives that make a real difference
Competitive Benefits – Enjoy great compensation, health benefits, PTO, and more!
Primary Focus:
Oversee Home Health and Hospice-specific processes, quality assurance, training, compliance, and client
relations to ensure operational excellence and client satisfaction.
Responsibilities:
1. Process Ownership
Develop, document, and refine workflows and best practices for Home Health and Hospice operations
Ensure compliance with all relevant regulations, including Conditions of Participation (COP)
2. Quality Assurance (QA)
Conduct comprehensive QA reviews of Home Health and Hospice documentation, including:
– Plan of Care
– OASIS/HIS
– Visit notes
– Coding
Identify and address quality gaps by collaborating with teams and implementing actionable solutions.
3. Training and Development
Design and implement training programs focused on Home Health and Hospice operations
Provide ongoing education on regulations, compliance, and workflows to maintain high-quality standards
4. Compliance and Documentation
Monitor adherence to Medicare/Medicaid guidelines and other compliance standards
Ensure all documentation is accurate, thorough, and meets audit and inspection requirements
5. Performance Improvement
Lead Quality Assessment and Performance Improvement (QAPI) initiatives
Collaborate with support teams to gather insights, establish benchmarks, and implement action plans for ongoing improvement
6. Client Communication and Management
Act as the subject matter expert and primary point of contact for Home Health and Hospice clients
Build and maintain strong client relationships to ensure satisfaction and retention
Manage all client communications, including emails, calls, and scheduled meetings
7. Team Coordination
Coordinate with operations teams to manage client feedback, updates, requests, priorities, and escalations
Act as a liaison between clients and internal teams to ensure seamless operations
8. Issue Resolution
Promptly address client complaints and inquiries, providing effective solutions
Work with internal teams to resolve escalations and implement corrective measures to prevent recurrence
9. Administrative Support
Prepare reports, presentations, and other necessary documentation
Track client cases, monitor project progress, and provide regular updates to stakeholders
What We’re Looking For:
3–5 years in Home Health/Hospice operations, QA, compliance, or clinical auditing
Proven experience in Home Health Quality Assurance and Performance Improvement (QAPI) program
Must have a clinical background and Home Health Coding and QA experiences
Strong knowledge of Medicare/Medicaid, CoP, and regulatory requirements
Experience in QA reviews (Plan of Care, OASIS/HIS, visit notes, coding)
Training, staff development, or process improvement experience
Client-facing experience with proven relationship-building skills
Ready to Elevate Your Career? Apply Today!
If you’re passionate about quality, compliance, and making a difference in Home Health & Hospice, we want to hear from you!
Apply now – Be part of a team that values excellence, innovation, and client satisfaction!
For interested applicants you may send your resume to [email protected] or [email protected]
Don’t miss this opportunity – Take the next step in your career today!
Job Type: Full-time
Benefits:
401(k)
Health insurance
Paid time off
Schedule:
8 hour shift
Monday to Friday
Work Location: Remote
Title: Eligibility Specialist III (Medicaid QA/Training)
Company: Forsyth County
Location: Winston-Salem, NC
