Governmental Audit Reviewer (RN)

About the role

The Governmental Audit Reviewer ensures that clinical documentation for home health, hospice, LTACH, and community‑based services meets the rigorous standards of governmental audits. As an RN with LPN licensure, you will lead the audit, appeal, and compliance processes that protect reimbursement and maintain audit readiness.

Key responsibilities

• Review clinical documentation in response to audits such as ADRs, RACs, CERTs, and ZPICs.
• Maintain consistency through standardized review processes and high inter‑rater reliability.
• Draft professional response letters and manage internal determinations for audit appeals.
• Coordinate appeal assignments, meet deadlines, and prepare documentation for Administrative Law Judge hearings.
• Stay current on federal and state regulations, industry standards, and internal policies.
• Collaborate across departments to minimize operational disruptions and communicate audit trends.
• Support the Governmental Audit Supervisor with repayment processes and additional compliance audits.

Required profile

• Associate’s degree in Nursing.
• Current, unrestricted LPN licensure.
• At least 1 year of experience in hospice, LTACH, or home health care.
• Working knowledge of reimbursement and compliance regulations.
• Proficiency with Microsoft Office applications.
• Preferred: Bachelor’s degree in Nursing, experience auditing clinical documentation, demonstrated leadership qualities.

Required skills

• Microsoft Word
• Microsoft Excel

What we offer

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase plan.
• 401(k) contribution.
• Competitive salary based on market, education, experience, and certifications.