Clinical Compliance Auditor - Nurse

(PACS) Providence Administrative Consulting Services, Inc.; United States; Remote; USD 93,000 - 115,000; Full time

Benefits offered by this job

Health insurance

Paid time off (PTO)

Financial wellness: HSA/FSA

401(k) retirement plan

Employee Assistance Program (EAP)

Job summary

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

The role promotes a compliant culture and adherence to CMS requirements while supporting quality improvement and accurate billing. This remote position requires strong analytical skills, extensive auditing experience, and the ability to work independently with minimal supervision.

Qualifications

• Active RN/LPN/LVN license is required.
• Bachelor’s degree preferred; other nursing certificates or associates acceptable.
• 5+ years of progressive leadership in compliance for skilled nursing facilities and MDS/reimbursement.
• Strong knowledge of Medicare/Medicaid documentation, coding and regulations.
• Certificates in coding/auditing (CPC/CCS/CHC) preferred; RAC-CT preferred.

Responsibilities

• Perform internal audits related to billing, documentation, therapy utilization, and coding accuracy.
• Analyze audit findings, identify trends and root causes, and report results.
• Partner with operations to implement corrective action plans and ensure timely follow-up.
• Conduct and/or support compliance investigations with thorough documentation.
• Deliver live and virtual training sessions in collaboration with operations.

Skills

Active Nursing License

Regulatory compliance

Auditing

Leadership in compliance

Education

Nursing certificate/Associate degree

Bachelor’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 400 post-acute care facilities with 50,000 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 & EXPERIENCE

• Active License Nursing (RN/LPN/LVN).
• A certificate in nursing or associate’s degree, required. A bachelor’s degree, preferred.
• 5+ years of progressive leadership in compliance and/or skilled nursing facilities, specifically with MDS and reimbursement.
• 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 with clinical auditing and 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.
• Demonstrated regional and/or compliance oversight experience managing multiple healthcare sites.
• 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 work independently with minimal supervision.
• Apply advanced knowledge and understanding of concepts, principles, and technical capabilities to manage audits and investigations.
• Possesses 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.

PHYSICAL DEMANDS

• Primarily sedentary role with extended periods of computer work.
• Occasional standing, walking, and light lifting (up to 10-20 lbs).
• Regular use of hands for typing and office equipment.
• Ability to read and review detailed documents.
• Clear verbal and written communication required.
• Occasional travel based on business needs.

WORK LOCATION

This role is remote, requiring less than 25% travel.

PAY

The range for this position is $93,000-$115,000 depending on experience, certifications and location.

BENEFITS

• 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.

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.