Nurse Practitioner Compliance Auditor

NHS Management, LLC; Tuscaloosa (AL); On-site; USD 95,000 - 120,000; Full time

Job summary

NHS Management, LLC seeks a Nurse Practitioner or Physician Assistant to support compliance activities in a Post Acute/Long Term Care setting. The role focuses on verifying adherence to CMS Medical Necessity standards and anti-kickback laws while auditing E/M encounters billed to Medicare, Medicaid, and third-party payers.

Responsibilities include reviewing random patient encounters, generating audit reports in Excel, ensuring privacy under HIPAA, and collaborating with facility staff and the

Qualifications

• Must be a Registered Nurse in good standing with Alabama licensure.
• Must be certified as a Nurse Practitioner or Physician Assistant and in good standing.
• Knowledge of Medical Necessity standards for E/M billing to Medicare/Medicaid.

Responsibilities

• Audit monthly patient encounters for CMS medical necessity and level of service.
• Create and review Excel-based audit reports with patient details and locations.
• Ensure HIPAA privacy and security in data handling and reporting.
• Collaborate with Practice Manager and facility staff to address audit findings.
• Provide training and guidance on compliance procedures as needed.

Skills

Registered Nurse license

CRNP or PA certification

EMR software knowledge

Education

RN license

CRNP/PA certification

Tools

EMR software

Job description

NHS Management, LLC seeks a Nurse Practitioner or Physician Assistant to support compliance activities in a Post Acute/Long Term Care setting. The role focuses on verifying adherence to CMS Medical Necessity standards and anti-kickback laws while auditing E/M encounters billed to Medicare, Medicaid, and third-party payers.

Responsibilities include reviewing random patient encounters, generating audit reports in Excel, ensuring privacy under HIPAA, and collaborating with facility staff and the