Compliance Auditor (SNF)

Job Description

Job Description

COMPETITIVE SALARY + FULL BENEFITS PACKAGE + UNLIMITED PTO + FAMILY ATMOSPHERE

Evolve Therapy Services, LLC is a leading therapy management organization in the Long-term care industry.  We may be a newer company by name, but our leadership has dozens of years of experience in therapy operations and clinical excellence for SNF/ALF providers.  We are seeking a Compliance Auditor that is  MOTIVATED  to work for a company with an  EVOLVING  culture that provides a  POSITIVE  work and life balance.

JOB SUMMARY:  The COMPLIANCE AUDITOR is responsible for assisting with the therapy audit/appeals process, including but not limited to, completing therapy audits, identifying trends, providing education, and participating in Additional Documentation Request (ADR) process in accordance with state and federal guidelines and regulations. The compliance auditor will report directly to the Director of Compliance.

RESPONSIBILITIES AND MAJOR DUTIES:

1. Ensure Medicare Benefit Policy Manual process is being followed in accordance with State & Federal guidelines.

2. Ensure the applicable Resident Assessment Instrument (RAI) process is followed in accordance with State and Federal Guidelines.

3. Complete and Review Therapy Medicare Audits to identify areas of opportunity and potential therapy trends.

4. Assist with preparing education for Regional Director of Operations to provide feedback, review trends, and identify solutions.

5. Prepare and participate in Additional Documentation Request (ADR) process, including preparing for ADR therapy cases and providing representation during scheduled hearings.

6. Attend and participate in all scheduled meetings, in-services, and all other meetings related to your employment.

7. Ensure compliance with all HIPAA regulations.

8. Always follow Residents’ Rights policies.

9. Adhere to all company policies & procedures.

10. Perform other related duties as directed by Director of Compliance and/or person of authority.

EDUCATION & REQUIREMENTS:

• Degree in Physical Therapy, Occupational Therapy, or Speech Language Pathology

• Must have active (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 requires and denials process.

Benefits:

• Competitive Compensation

• Medical, Dental, Vision and other voluntary benefits available

• Unlimited Paid Time Off