Remote Clinical Compliance Auditor RN

PACS Group; United States; Remote; USD 93.000 - 115.000; Vollzeit

Benefits dieser Stelle

Health coverage

PTO & holidays

HSA/FSA

Zusammenfassung

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

The role supports quality improvement and ensures adherence to federal, state, and local regulations including CMS requirements. Reporting to the Senior Director of Clinical Audit, you will work independently with strong attention to detail, travel less than 25%, and promote a culture of compliant,

Qualifikationen

• Active Nursing license (RN/LPN/LVN) required.
• Nursing certificate or an associate degree required; bachelor’s degree preferred.
• 5+ years of progressive leadership in compliance in skilled nursing or related post-acute settings (MDS and reimbursement).
• Strong knowledge of Medicare/Medicaid documentation, coding and regulations.

Aufgaben

• Complete internal audits related to billing, reimbursement accuracy, documentation integrity, therapy utilization and coding.
• Analyze audit findings to identify trends and root causes.
• Partner with operations to implement corrective action plans and ensure timely follow-up.
• Conduct and/or partner on compliance investigations with timely, objective documentation.
• Deliver live and virtual training sessions in collaboration with operations.
• Collaborate across departments (operations, finance, HR, IT) to improve controls.
• Provide regular updates on investigation and audit results and prepare reports.

Kenntnisse

Regulatory leadership

Medicare/Medicaid knowledge

Auditing

Analytical skills

Communication

Ausbildung

Nursing certificate or associate degree

Bachelor’s degree preferred

Tools

AAPC certification

AHIMA certification

HCCA certifications

RAC-CT preferred

Jobbeschreibung

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

The role supports quality improvement and ensures adherence to federal, state, and local regulations including CMS requirements. Reporting to the Senior Director of Clinical Audit, you will work independently with strong attention to detail, travel less than 25%, and promote a culture of compliant,