Clinical Compliance Auditor II - Therapy

(PACS) Providence Administrative Consulting Services, Inc.; United States; Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health Coverage

Paid Time Off

Health Savings Account

401(k) plan

Employee Assistance Program

Job summary

PACS Group, Inc. is seeking a Clinical Compliance Auditor II to conduct comprehensive clinical audits of documentation, regulatory practices, and reimbursement processes for Skilled Nursing Facilities and post-acute settings.

The role supports quality improvement, ensures CMS compliance, and promotes accurate billing and documentation. Remote work with <25% travel, collaboration across operations, finance, HR and IT is expected.

Qualifications

• Active PT or OT license; bachelor’s degree required.
• Master’s degree preferred.
• 5+ years in compliance or skilled nursing facilities.
• Familiar with Medicare/Medicaid documentation and coding.
• Certifications: AAPC/AHIMA/HCCA preferred.

Responsibilities

• Perform internal audits of billing, documentation, and coding.
• Analyze findings to identify trends and root causes.
• Collaborate with operations to implement corrective actions.
• Lead or support compliance investigations with thorough documentation.
• Deliver live and virtual training with operations teams.
• Provide regular updates and reports on audits.

Skills

Analytical capabilities

Attention to detail

Communication skills

Time management

Confidentiality

Education

Bachelor's degree

Master's degree

Tools

AAPC

AHIMA

HCCA

CPC

CCS

CCS-P

COC

CPMA

CHC

RAC-CT

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

Join PACS

PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide. If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let's shape the future of healthcare!

Join Our Team and Thrive!

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.

• 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.

Join us at PACS and take advantage of a workplace that truly values you!

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.

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.

PACS is revolutionizing the delivery and leadership of post-acute healthcare and support services across the country. Originally founded in 2013, the organization now consists of hundreds of independent operating subsidiaries, as well as ancillary and support services. We bring a proven model of mission-driven care that balances access to a national network of support and resources with local decision making. In addition, PACS helps connect exceptional people with premier healthcare careers across the country. We focus on finding innovative and effective team members based on their qualifications, experience, geographic preferences, and personality fit with the existing facility staff and culture. 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.