Compliance Auditor (SNF)

Evolve Therapy Services, LLC is a leading therapy management organization in the Long‑term care industry. Our leadership has dozens of years of experience in therapy operations and clinical excellence for SNF/ALF providers. We are seeking a Compliance Auditor who 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 the 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

Ensure Medicare Benefit Policy Manual process is being followed in accordance with State & 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 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 all other meetings related to employment. Ensure compliance with all HIPAA regulations. Always follow Residents’ Rights policies. Adhere to all company policies & procedures. 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) license in state(s) of practice. Must maintain ongoing continuing education and professional development to keep licensure and certification current. Knowledge of CMS guidelines for documentation requirements and denial processes.

BENEFITS

Competitive Compensation Medical, Dental, Vision and other voluntary benefits available Unlimited Paid Time Off #J-18808-Ljbffr Evolve Therapy Services, LLC