Director of Clinical Compliance
On-siteChicago, Illinois, United States
Job Summary
Lead and strengthen Thrive's enterprise clinical compliance program, including policies, audits, training, and corrective actions. Personally perform detailed chart, coding, billing, documentation, and Medicare audits across outpatient therapy practices. Evaluate CPT, HCPCS, ICD-10, and plan-of-care certification to identify risks before and after new partnerships. Navigate multiple EMR platforms to review clinical documentation and billing, then translate findings into practical training for clinicians and operational leaders. Provide clear risk reporting to the CEO, COO, and Compliance Committee while building a culture where compliance is approachable and integrated into everyday operations.
Required Qualifications
- Strong preference for a degree and license credential in Physical, Occupational or Speech Pathology
- Strong knowledge of outpatient physical, occupational, and speech therapy compliance, documentation, coding, billing, and payer requirements
- Approximately 3 to 5 or more years of relevant outpatient therapy, compliance, coding, auditing, billing, or Medicare experience
- Advanced knowledge of Medicare requirements, including plan-of-care certification, billing methodology, provider-of-service rules, ABNs, and covered versus non-covered services
- Demonstrated ability to independently perform detailed chart, coding, billing, documentation, and Medicare audits
- The judgment to distinguish isolated errors from broader patterns or systemic risk
- Experience building repeatable compliance processes, audit tools, reporting formats, training programs, and follow-up systems
- The ability to communicate complex compliance requirements in clear, practical, and usable terms
- Strong writing skills, including the ability to prepare concise audit summaries, action plans, risk assessments, and executive updates
- Confidence coaching clinicians and operational leaders through sensitive findings without creating unnecessary defensiveness
- Strong cross-functional influence, judgment, discretion, and follow-through
- Comfort navigating multiple EMR systems and extracting the information needed to evaluate risk
- The ability to manage competing priorities and move between strategic program development and detailed execution
Desired Qualifications
- Certified Professional Medical Auditor (CPMA) strongly preferred
- CPC, CHC, COC, CCS-P, or another relevant compliance, coding, or auditing credential is also valued
- Equivalent experience conducting complex outpatient therapy audits may be considered in place of certification
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