Compliance Clinical Auditor I - Therapy

PACS

8d • Remote

About The Position

The Clinical Compliance Auditor I conducts routine audits of clinical documentation, regulatory compliance practices, and reimbursement-related processes for Skilled Nursing Facilities. The role supports adherence to federal, state, and local regulations, including CMS requirements, and contributes to quality improvement by promoting accurate clinical documentation and billing practices.

The auditor analyzes findings, identifies trends and root causes, collaborates with operations and clinical operations on corrective action plans, and conducts or partners on timely, objective, well-documented compliance investigations. The role also delivers live and virtual training, collaborates across functions, and provides updates and reports on audit and investigation results.

This is a remote role requiring less than 25% travel. Preferred locations are Utah, Montana, North Dakota, South Dakota, New Mexico, and Texas. The work is primarily sedentary, with extended computer use and occasional standing, walking, and light lifting.

Requirements

• Active Physical Therapy (PT) or Occupational Therapy (OT) license.
• Bachelor’s degree.
• At least 3 years of increasing responsibility in compliance and/or skilled nursing facilities, specifically regional therapy services and/or dedicated compliance roles, with oversight experience supporting multiple healthcare sites.
• Deep understanding and application of Medicare and Medicaid documentation, coding, and regulations.
• Prior experience conducting audits and/or internal investigations in a healthcare setting.
• Strong analytical capabilities, excellent communication, attention to detail, and ability to work in a dynamic, fast-paced setting.
• Ability to carry out responsibilities with minimal supervision.
• Ability to apply knowledge and understanding of concepts, principles, and technical capabilities to manage audits and investigations.
• Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment.
• Excellent time management, personal integrity, and ability to maintain confidentiality.
• Effective written and verbal communication.

Nice To Haves

• Master’s degree.
• AAPC, AHIMA, or HCCA coding certification and/or auditing or compliance certification, such as CPC, CCS, CCS-P, COC, CPMA, or CHC.
• RAC-CT certification.

Responsibilities

• Complete internal audits related to billing and reimbursement accuracy, documentation integrity, therapy utilization and coding, quality, and clinical documentation.
• Analyze audit findings to identify trends and root causes.
• Partner with operations and clinical operations to implement corrective action plans and ensure timely follow-up.
• Conduct or partner on compliance investigations, ensuring they are completed promptly, objectively, and with appropriate documentation.
• Deliver live and virtual training sessions in collaboration with operations and clinical operations.
• Collaborate across the organization, including with operations, clinical operations, finance, HR, and IT.
• Provide regular updates on investigation and audit results and prepare reports.

Benefits

• Medical, dental, and vision plans.
• Paid time off and holidays.
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
• 401(k) plan with company contributions.
• Employee Assistance Plan (EAP) providing confidential support.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level