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Pdpm Audit Jobs in Washington (NOW HIRING)

HiredFirst

DIRECTOR OF REHABILITATION (DOR)

Waldorf, MD · On-site

$93K/yr

Ensure Medicare/PDPM and regulatory compliance * Manage therapy scheduling, caseloads, and productivity * Coordinate interdisciplinary resident care plans * Oversee quality improvement, audits, and ...

Healthbridge Staffing

Corporate MDS Traveler

Fairfax, VA · Hybrid

$90K - $100K/yr

Ensure compliance with state and federal regulations, Medicare requirements, PDPM, case-mix, and ... Support centers during staffing transitions, audits, or high census periods * Participate in ...

Montcare Potomac

MDS coordinator

Potomac, MD · On-site

$80K - $90K/yr

Perform audits and quality assurance reviews related to MDS and care planning * Stay current with ... Experience with Medicare/Medicaid case mix and PDPM * Prior experience in a leadership or ...

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Pdpm Audit information

What is a PDPM audit?

A PDPM audit is an evaluation process that reviews how a skilled nursing facility implements the Patient-Driven Payment Model (PDPM). Auditors examine clinical documentation, coding, and billing practices to ensure compliance with Medicare regulations and to verify that residents are being accurately assessed and classified for payment. The goal is to identify errors or discrepancies that could lead to improper payments or regulatory issues, and to help facilities improve their processes for accurate reimbursement. Regular PDPM audits can help facilities avoid penalties and maintain financial stability.

What are the key skills and qualifications needed to thrive as a PDPM auditor?

To thrive as a PDPM Auditor, you need a solid understanding of Medicare reimbursement systems, MDS (Minimum Data Set) assessments, and skilled nursing facility regulations, typically supported by clinical credentials such as RN, LPN, or certification in MDS/RAI. Familiarity with electronic health record (EHR) systems, PDPM calculation software, and audit tools is essential. Strong analytical thinking, attention to detail, and effective communication skills help ensure accuracy and clarity when reviewing records and providing feedback. These skills are vital to optimize reimbursement, maintain regulatory compliance, and support quality patient care.

What are some common challenges faced by professionals conducting PDPM audits in skilled nursing facilities?

Professionals performing PDPM (Patient-Driven Payment Model) audits often encounter challenges such as ensuring accurate clinical documentation, keeping up with frequent regulatory changes, and effectively communicating findings to interdisciplinary teams. They must carefully review MDS assessments, therapy documentation, and nursing notes to verify compliance and reimbursement accuracy. Additionally, working collaboratively with clinical and administrative staff is crucial for implementing corrective actions and maintaining ongoing compliance.

What is the difference between Pdpm Audit vs Pdpm Compliance Officer?

AspectPdpm AuditPdpm Compliance Officer
Primary RoleConducts audits to ensure adherence to Pdpm standards and regulationsEnsures organizational compliance with Pdpm policies and external regulations
CertificationsOften requires auditing or quality assurance certificationsRequires compliance or regulatory certifications
Work EnvironmentAuditing in various departments, often in a review or assessment capacityMonitoring and implementing compliance measures across the organization
Industry UsageCommon in healthcare, manufacturing, and service sectorsPrevalent in healthcare, finance, and regulated industries

While both roles focus on adherence to Pdpm standards, Pdpm Audits primarily evaluate compliance through assessments, whereas Pdpm Compliance Officers develop and oversee compliance programs to ensure ongoing adherence.

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Pdpm Audit jobs near you

DIRECTOR OF REHABILITATION (DOR)

HiredFirst

Waldorf, MD • On-site

$93K/yr

Full-time

Re-posted 12 days ago

Job description

DIRECTOR OF REHABILITATION (DOR) – PERMANENT (SNF)

Location: CA 95901
Schedule: Permanent position

Compensation:

  • Up to $$93,600 annually

Position Summary & Responsibilities (SNF)

  • Lead SNF rehab department operations and staff

  • Ensure Medicare/PDPM and regulatory compliance

  • Manage therapy scheduling, caseloads, and productivity

  • Coordinate interdisciplinary resident care plans

  • Oversee quality improvement, audits, and staff development

Requirements

  • Licensed PT, OT, COTA, or SLP

  • SNF or post-acute rehab experience required

  • Leadership or supervisory experience preferred

  • Knowledge of Medicare/PDPM and documentation standards