RN Compliance Audit Specialist – Quality & Payor

Community Hospice and Palliative Care

Jacksonville (FL)

On-site

USD 65,000 - 90,000

Full time

7 days ago

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Benefits offered by this job

23 days PTO

Job summary

Community Hospice & Palliative Care in Jacksonville seeks a Compliance Audit Specialist to lead medical record reviews and audits, ensuring adherence to internal policies and external regulations. The role supports the Quality and Compliance program and training development.

You will work full-time at our main location, Monday–Friday, with a benefits package. Required RN licensure in Florida and 3–5 years of healthcare auditing experience are essential, along with strong analytical skills and

Qualifications

RN licensure in the state of Florida.
Bachelor’s degree preferred, in nursing or business-related field.
3–5 years of healthcare auditing or medical chart review experience.

Responsibilities

Performs medical records reviews to ensure regulatory compliance.
Assist with audit design and independently completes reviews.
Consults with staff to clarify clinical data and educate on payor requirements.
Processes documentation requests from Medicare, Medicaid and third-party payors.
Identifies denials and supports documentation improvements.
Coordinates the appeals process and maintains tracking logs.
Provides updates to the Director of Quality and Risk Manager.