Compliance Clinical Auditor I - Therapy

PACS Group, Inc. is a holding company investing in post-acute healthcare facilities, professionals, and ancillary services. Founded in 2013, PACS Group is one of the largest post-acute platforms in the United States, operating 325 post-acute care facilities with 47,000 employees across 17 states serving over 31,000 patients daily. PACS Services, the business support division, provides technology and administrative support—including accounting, finance, HR, compliance, payroll, AR/AP, legal, risk management, IT, and corporate communications—to reduce administrative burdens and allow care teams to focus on patient well-being.

About the role

The Clinical Compliance Auditor I conducts routine audits of clinical documentation, regulatory compliance practices, and reimbursement-related processes for Skilled Nursing Facilities. This role ensures adherence to federal, state, and local regulations, including CMS requirements, supports quality improvement initiatives, and promotes accurate clinical documentation and billing practices.

Responsibilities

• Complete internal audits related to billing and reimbursement accuracy, documentation integrity, therapy utilization and coding, quality, and clinical documentation.
• Analyze audit findings to identify trends and root causes.
• Partner with operations and clinical teams to implement corrective action plans and ensure timely follow-up.
• Conduct and/or support compliance investigations, ensuring they are completed timely, objectively, and well-documented.
• Deliver live and virtual training sessions in collaboration with operations and clinical teams.
• Collaborate cross-functionally across the organization, including operations, clinical operations, finance, HR, and IT teams.
• Provide regular updates on investigation and audit results and prepare reports.

Requirements

• Active License in Physical Therapy (PT) or Occupational Therapy (OT).
• Bachelor’s degree required; Master’s degree preferred.
• AAPC, AHIMA, or HCCA Coding certification and/or Auditing/Compliance certification (CPC, CCS, CCS-P, COC, CPMA, CHC) preferred.
• RAC-CT preferred.
• 3+ years of increasing responsibility in compliance and/or skilled nursing facilities, specifically in regional therapy services or dedicated compliance roles, with oversight experience supporting multiple healthcare sites.
• Deep understanding and application of Medicare and Medicaid documentation, coding, and regulations.
• Prior experience conducting audits and/or internal investigations in a healthcare setting.
• Strong analytical capabilities, excellent communication, attention to detail, and ability to work in a dynamic, fast-paced setting.

Expectations

• Ability to carry out responsibilities with minimal supervision.
• Apply knowledge and understanding of concepts, principles, and technical capabilities to manage audits and investigations.
• Effectively prioritize and execute tasks in a fast-paced, dynamic environment.
• Excellent time management, personal integrity, and ability to maintain confidentiality.
• Effective written and verbal communication.

Physical Demands

• Primarily sedentary role with extended periods of computer work.
• Occasional standing, walking, and light lifting (up to 10-20 lbs).
• Regular use of hands for typing and office equipment.
• Ability to read and review detailed documents.
• Clear verbal and written communication required.
• Occasional travel based on business needs.

Schedule

This role is remote, requiring less than 25% travel. Preferred locations: Utah, Montana, North Dakota, South Dakota, New Mexico, Texas.

Benefits

• Health Coverage: Medical, dental, and vision plans.
• PTO and Vacation: Generous paid time off and holidays.
• Financial Wellness: Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
• Retirement Planning: 401(k) plan with company contributions.
• Support: Employee Assistance Plan (EAP) for confidential personal and professional support.