Senior Remote Clinical Compliance Auditor (Nurse)

PACS; Salt Lake City (UT); Remote; USD 93,000 - 115,000; Full time

Benefits offered by this job

Health Coverage

PTO and Vacation

401(k) Plan

Job summary

PACS Group, Inc. is seeking an experienced Clinical Compliance Auditor II to perform comprehensive clinical audits, ensure CMS and state regulatory compliance, and promote accurate documentation and billing practices.

The role supports post-acute care operations with a focus on quality and compliance across sites. This is a remote role with less than 25% travel; candidates should have extensive Medicare/Medicaid experience and relevant certifications.

Qualifications

• Active nursing license (RN/LPN/LVN) and current licensure.
• Certificate in nursing or an associate degree required; bachelor’s preferred.
• 5+ years of leadership in compliance, specifically with MDS and reimbursement.
• Strong understanding of Medicare and Medicaid documentation, coding and regulations.
• AAPC/AHIMA/HCCA coding or auditing certifications preferred (CPC, CCS, CCS-P, COC, CPMA, CHC). RAC-CT preferred.

Responsibilities

• Complete internal audits related to billing and 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 follow-up.
• Conduct/combine on compliance investigations with timely, objective documentation.
• Deliver live and virtual trainings in collaboration with operations.
• Collaborate across functions including operations, finance, HR and IT.
• Provide regular updates and prepare audit reports.

Skills

RN/LPN/LVN license

5+ years leadership in compliance

Medicare/Medicaid documentation

Auditing/compliance certifications

Clinical auditing experience

Attention to detail

Communication skills

Education

Nursing certificate/associate degree

Bachelor’s degree preferred

Job description

PACS Group, Inc. is seeking an experienced Clinical Compliance Auditor II to perform comprehensive clinical audits, ensure CMS and state regulatory compliance, and promote accurate documentation and billing practices.

The role supports post-acute care operations with a focus on quality and compliance across sites. This is a remote role with less than 25% travel; candidates should have extensive Medicare/Medicaid experience and relevant certifications.