Compliance Auditor (SNF)

Evolve Therapy Services, LLC is a leading therapy management organization in the Long-term care industry. Our leadership has decades of experience in therapy operations and clinical excellence for SNF/ALF providers. We foster an evolving culture that promotes a positive work-life balance within a family-like atmosphere.

About the role

The Compliance Auditor is responsible for assisting with the therapy audit and appeals process, including completing therapy audits, identifying trends, providing education, and participating in the Additional Documentation Request (ADR) process in accordance with state and federal guidelines and regulations. This role reports directly to the Director of Compliance.

Responsibilities

• Ensure the Medicare Benefit Policy Manual process is followed in accordance with state and federal guidelines.
• Ensure the applicable Resident Assessment Instrument (RAI) process is followed in accordance with state and federal guidelines.
• Complete and review therapy Medicare audits to identify areas of opportunity and potential therapy trends.
• Assist with preparing education for the Regional Director of Operations to provide feedback, review trends, and identify solutions.
• Prepare and participate in the Additional Documentation Request (ADR) process, including preparing for ADR therapy cases and providing representation during scheduled hearings.
• Attend and participate in all scheduled meetings, in-services, and other employment-related meetings.
• Ensure compliance with all HIPAA regulations.
• Always follow Residents’ Rights policies.
• Adhere to all company policies and procedures.
• Perform other related duties as directed by the Director of Compliance or person of authority.

Requirements

• Degree in Physical Therapy, Occupational Therapy, or Speech Language Pathology.
• Active license (PT, PTA, OT, OTA, SLP) in state(s) of practice.
• Ongoing continuing education and professional development to maintain current licensure and certification.
• Knowledge of CMS guidelines for documentation requirements and denials process.

Benefits

• Competitive compensation.
• Medical, dental, vision, and other voluntary benefits.
• Unlimited paid time off.