Clinical Compliance Auditor II - Therapy

PACS

Salt Lake City (UT)

Remote

USD 90,000 - 120,000

Full time

5 days ago
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Benefits offered by this job

Health Coverage
PTO and Vacation
Health Savings Account (HSA)
Flexible Spending Accounts (FSA)
401(k) plan
Employee Assistance Plan (EAP)

Job summary

PACS Group, Inc. is seeking a Clinical Compliance Auditor II to lead comprehensive audits of clinical documentation, regulatory compliance, and reimbursement processes in post-acute care settings.

You will ensure adherence to CMS and state regulations, support quality initiatives, and promote accurate documentation and billing practices. The role involves cross-functional collaboration with operations, finance, HR, and IT, plus delivering trainings and investigations as needed.

Qualifications

  • Active PT or OT license.
  • 5+ years in compliance or skilled nursing facilities with oversight across multiple sites.
  • Deep understanding of Medicare/Medicaid documentation and coding.
  • AAPC/AHIMA/HCCA certifications preferred (CPC/CCS/CCS-P/COC/CPMA/CHC); RAC-CT preferred.
  • Auditing/investigations experience in a healthcare setting.

Responsibilities

  • Conduct internal audits of billing, documentation, therapy utilization and coding.
  • Analyze audit findings to identify trends and root causes.
  • Partner with operations to implement corrective action plans and ensure follow-up.
  • Conduct or partner on compliance investigations with timely, objective documentation.
  • Deliver live and virtual training with operations and clinical teams.

Skills

PT/OT license

Education

Bachelor's degree
Master's degree preferred

Job description

COMPANY OVERVIEW

PACS Group, Inc. is a holding company investing in post-acute healthcare facilities, professionals, and ancillary services. Founded in 2013, PACS Group is one of the largest post-acute platforms in the United States. Its independent subsidiaries operate 325 post-acute care facilities with 47,000 employees across 17 states serving over 31,000 patients daily. PACS business support division, PACS Services, provides technology and administrative support services — accounting, finance, human resources, compliance, payroll, AR/AP, legal, risk management, information technology, corporate communication, and other business advice and support — to their healthcare facilities, reducing administrative burdens so their leadership and care teams can focus on the care, well-being, and quality of life of their patients and residents. PACS is one of Utah's Best Companies to work for. It has also been recognized as one of Utah's Fastest Growing Companies for multiple years.

JOB SUMMARY

Reporting to the Senior Director of Clinical Audit, the Clinical Compliance Auditor II is an advanced-level compliance professional responsible for conducting comprehensive clinical audits of clinical documentation, regulatory compliance practices, and reimbursement related processes related to Skilled Nursing Facilities and related post‑acute care settings. This position will promote strong, compliant, and values‑aligned culture. The role ensures adherence to federal, state, and local regulations including CMS requirements, supports quality improvement initiatives, and promotes accurate clinical documentation and billing practices.

Essential Duties
  • 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 and or partner on compliance investigations, ensuring completed timely, objectively and well documented.
  • Deliver live and virtual training sessions in collaboration with operations and clinical operations.
  • Cross functional collaboration across the organization, including (but not limited to) operations, clinical operations, finance, HR and IT teams.
  • Provide regular updates on investigation and audit results and prepare reports.
Qualifications and Experience
  • Active License in Physical Therapy (PT) or Occupational Therapy (OT).
  • A bachelor's degree, required. Master's degree, preferred.
  • 5+ years of increasing levels of responsibility in compliance and/or skilled nursing facilities. Specifically regional therapy services and or dedicated compliance roles, with oversight experience supporting multiple healthcare sites.
  • A deep understanding and application of Medicare and Medicaid documentation, coding and regulations.
  • AAPC, AHIMA or HCCA Coding certification and or Auditing/Compliance certification (CPC, CCS, CCS‑P, COC, CPMA, CHC) preferred. RAC-CT preferred.
  • Prior experience conducting audits and or conducting internal investigations, in a healthcare setting.
  • Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; recommends opportunities to strengthen the internal control structure.
  • Strong analytical capabilities, excellent communication, attention to detail, and ability to work in a dynamic, fast‑paced setting.
WHAT IS EXPECTED OF YOU AT THIS LEVEL
  • Ability to carry out responsibilities with minimal supervision.
  • Apply advanced knowledge and understanding of concepts, principles, and technical capabilities to manage audits and investigations.
  • Possess strong attention to detail.
  • Ability to effectively prioritize and execute tasks in a fast‑paced, dynamic environment.
  • Excellent time management, personal integrity and ability to maintain confidentiality.
Work Location
  • This role is remote, requiring less than 25% travel.
  • Preferred locations- Utah, Montana, North Dakota, South Dakota, New Mexico, Texas
Our Comprehensive Benefits Include
  • Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
  • PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
  • Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
  • Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
  • Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.

At PACS, we believe our employees are our greatest asset. That's why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.

We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of every race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and any other protected characteristic. Employment decisions are based on qualifications, merit, and business needs.

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