Hospice Clinical Compliance & Audit Associate Director (Remote)

Position Summary

The Hospice Clinical Compliance & Audit Associate Director is responsible for oversight of hospice intake compliance and execution of comprehensive clinical audit activities across the organization. This role ensures documentation accuracy, regulatory compliance, and claim readiness through structured pre-bill reviews, targeted audits, and collaboration with clinical and operational teams. The position strengthens audit readiness, reduces financial risk, and supports revenue cycle efficiency while improving clinical documentation practices.

Clinical Audit & Pre-Bill Review

• Conduct pre-bill clinical chart audits to ensure compliance with Medicare hospice regulations
• Validate documentation supporting terminal prognosis, eligibility, and level of care
• Review face-to-face encounters, certifications, and recertifications
• Identify and escalate compliance risks prior to claim submission

Hospice Intake Oversight

• Provide ongoing education and guidance to Intake teams on eligibility and documentation standards
• Ensure eligibility criteria are clearly supported and documented
• Partner with intake teams to resolve documentation gaps in real time

External Audit Support

• Perform focused pre-bill audits in preparation for and response to external audits
• Monitor findings and identify trends requiring corrective action
• Support preparation, response, and coordination for external audits (including TPE-related activity)

Specialized Review Areas

• Long Length of Stay (LLOS) reviews
• General Inpatient (GIP) level of care review
• Continuous Care and Respite documentation validation
• Recertification technical and clinical reviews

Compliance Monitoring & Reporting

• Track audit outcomes and identify trends
• Maintain audit tools and reporting mechanisms
• Communicate findings to leadership

Education & Performance Improvement

• Translate audit findings into actionable feedback
• Assist in development of education materials
• Partner with clinical leadership to improve documentation

Collaboration

• Work closely with Compliance, Clinical, Revenue Cycle, and Intake teams
• Support audit readiness
• Promote a culture of compliance

Qualifications

• RN required
• Bachelor’s degree preferred
• 5+ years hospice experience
• 3+ years compliance/audit experience

Benefits

• Full-time employees qualify for Medical, Dental, Vision and supplementary benefits such as Life Insurance, Short Term and Long Term Disability