Clinical Compliance Coordinator

Appone; California (MO); On-site; USD 4,822,000 - 6,199,000; Full time

Benefits offered by this job

401(k)

Health insurance

Paid time off

Vision insurance

Dental insurance

Job summary

Appone seeks a Clinical Compliance Coordinator (LVN) to support the organization’s QAPI program, ensuring quality, accuracy, completeness, and timeliness of clinical documentation. This role conducts audits to verify compliance with Medicare/state rules and internal standards.

The LVN will work with the Director of Patient Care Services and the interdisciplinary team to identify deficiencies, monitor quality indicators, and promote continuous improvement in patient care.

Qualifications

• Current, unrestricted California LVN license.
• Graduate of an accredited vocational/practical nursing program.
• Minimum two years of licensed nursing experience; home health preferred.
• Experience in quality assurance, chart auditing, or documentation review preferred.
• Strong knowledge of Medicare/CMS CoPs and state regulations.

Responsibilities

• Review medical records and clinical documentation for quality, accuracy, timeliness.
• Conduct audits to ensure compliance with policies, Medicare rules, and regulations.
• Monitor documentation for CoPs, state regulations, and payer requirements.
• Develop and perform QAPI audits and quality-monitoring activities.
• Collaborate with leadership to resolve documentation discrepancies and drive corrective actions.
• Educate staff on documentation standards and quality improvement opportunities.
• Maintain audit records and support compliance readiness activities.

Skills

Attention to detail

HIPAA compliance

EMR/EHR proficiency

Quality Assurance

Documentation review

Education

Licensed Vocational Nurse (LVN) license

Graduate of an accredited practical nursing program

Tools

WellSky/Kinnser

Job description

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Description

Job Description Summary

The Clinical Compliance Coordinator (LVN) is responsible for supporting the organization's Quality Assurance and Performance Improvement (QAPI) program and ensuring the quality, accuracy, completeness, and timeliness of clinical documentation. This position conducts comprehensive medical-record reviews and audits to evaluate compliance with organizational policies, Medicare requirements, applicable federal and state regulations, and established clinical standards.

The Clinical Compliance Coordinator works closely with the Director of Patient Care Services, clinical leadership, and the interdisciplinary care team to identify documentation deficiencies, monitor quality indicators, support corrective actions, and promote continuous improvement in the delivery of patient care.

Essential Duties and Responsibilities

• Review patient medical records and clinical documentation to evaluate the quality, accuracy, completeness, consistency, and timeliness of services provided.

• Conduct routine and focused medical-record and clinical documentation audits to ensure compliance with agency policies, Medicare requirements, applicable laws, regulations, and accreditation standards.

• Review nursing and other clinical documentation to ensure that notes are accurate, detailed, clinically appropriate, and completed within required timeframes.

• Monitor documentation for compliance with applicable Medicare Conditions of Participation (CoPs), state regulations, payer requirements, and organizational standards.

• Develop, implement, and complete Quality Assurance and Performance Improvement (QAPI) audits and other quality-monitoring activities.

• Identify documentation deficiencies, compliance risks, trends, and opportunities for improvement and communicate findings to appropriate clinical leadership.

• Collaborate with the Director of Patient Care Services and clinical management to resolve documentation discrepancies and implement appropriate corrective actions.

• Work collaboratively with the interdisciplinary care plan team to evaluate the quality and appropriateness of patient care and supporting documentation.

• Review plans of care, assessments, physician orders, visit documentation, and other clinical records for consistency and regulatory compliance.

• Assist with monitoring administrative and clinical claims documentation to support accurate, compliant reimbursement.

• Maintain current knowledge of Medicare/CMS requirements, state regulations, QAPI standards, accreditation requirements, and applicable healthcare laws.

• Support regulatory and accreditation readiness activities, including internal audits, mock surveys, corrective action plans, and follow-up monitoring.

• Track audit findings and quality indicators and assist with identifying trends requiring performance improvement.

• Provide feedback and education to clinical staff regarding documentation standards, compliance requirements, and quality improvement opportunities.

• Participate in in-services, staff meetings, case conferences, QAPI meetings, and quality improvement activities as required.

• Maintain accurate audit records, reports, compliance documentation, and quality-improvement data.

• Promote a culture of accountability, patient safety, regulatory compliance, and continuous quality improvement.

• Perform other duties and responsibilities as assigned that are consistent with the position and organizational needs.

Qualifications and Requirements

• Current, unrestricted California Licensed Vocational Nurse (LVN) license.

• Graduate of an accredited vocational/practical nursing program.

• Minimum of two (2) years of licensed nursing experience, with at least one (1) year of home health experience preferred/required.

• Previous experience in quality assurance, clinical compliance, QAPI, chart auditing, utilization review, or clinical documentation review strongly preferred.

• Working knowledge of Medicare/CMS Conditions of Participation, California regulations, and home health documentation requirements.

• Familiarity with clinical documentation, medical-record auditing, quality improvement principles, and regulatory compliance.

• Strong computer skills and ability to work effectively with electronic medical record (EMR/EHR) systems.

• Excellent attention to detail with the ability to identify documentation discrepancies, compliance gaps, and quality trends.

• Strong analytical, organizational, time-management, and problem-solving skills.

• Excellent written and verbal communication skills.

• Ability to work independently while effectively collaborating with clinical leadership and interdisciplinary teams.

• Ability to maintain confidentiality and comply with HIPAA and applicable privacy requirements.

Preferred Qualifications

• Experience with home health QAPI programs.

• Experience reviewing OASIS assessments, Plans of Care, physician orders, visit documentation, and recertification/discharge documentation.

• Familiarity with Medicare billing and documentation requirements.

• Experience with regulatory surveys, accreditation preparation, mock audits, and corrective action plans.

• Experience with home health EMR platforms such as WellSky/Kinnser or similar systems.

Compensation

Pay Range: $35.00-$45.00 per hour, depending on qualifications, experience, and applicable organizational compensation guidelines.

Benefits:

• 401(k)
• Health insurance
• Paid time off
• Vision insurance
• Dental insurance