Provider Auditor II
Company: Noridian Healthcare Solutions
Posted on: November 19, 2018
Requisition Number 18-0893 Post Date 11/12/2018 Title Provider Auditor II - 300149 City All Locations Description Position is eligible for Remote/Work from Home opportunity Job Summary The Provider Auditor is responsible for conducting Centers for Medicare & Medicaid Services (CMS) and other financial analysis, limited and full desk reviews, and in-house and on-site field audits to ensure proper reimbursement for health care providers for the Medicare programs. Key Performance Indicators Meets CMS standards while maintaining departmental performance expectations Excellent attention to detail Ability to prioritize and multi-task workload FLSA Category: Non-Exempt Key Duties/Responsibilities/Accountabilities Develops a working knowledge of Medicare reimbursement principles and the Medicare Cost Report. Participates in the planning, organizing, and coordinating of the desk review process. Assists Provider Auditor II & Senior Provider Auditor with in-house and on-site field audits. Assists Provider Auditor II & Senior Provider Auditor in calculating limits and exceptions and completing wage index desk reviews. Develops and maintains a positive working relationship with providers. Possesses an intermediate level of working knowledge of Medicare reimbursement principles and the Medicare Cost Report. Identifies areas of opportunity and provides solutions for efficiency and process improvement. Provides support and input for specialized and in-depth projects with increased complexity. Handles cost report re-openings and appeals. May lead basic in-house and on-site field audits. Non-Essential Duties and Functions Other duties as assigned Requirements Qualifications Minimum Qualifications: Bachelor's degree in Accounting, Business, Finance or equivalent work experience Knowledge of accounting theory and practices Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint) 1-year Medicare auditing experience Demonstrated knowledge of Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software) Preferred Qualifications: Bachelor's degree in Accounting, Business or Finance. Excellent written and verbal communication skills Excellent organizational skills Environment and Cognitive/Physical Demands Office Environment Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve Requires prolonged sitting and telephone usage Requires the use of office equipment such as computer terminals, telephones, copiers and printers Infrequent lifting up to 15 pounds Infrequent stooping Ability to travel Segregation of Duties Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to, Segregation of Duties Principles, HIPAA Security and Privacy, CMS requirements, the Noridian Compliance Program, and any other applicable laws, rules and regulations. Statement of Other Duties This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description, and may be required to perform any task requested by the supervisor or by management. CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with (i) federal and agency-specific regulations and related clauses included in NHS's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card. Other Information Job Posting Policy 6.05 New employees with Noridian Healthcare Solutions will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply. Equal Employment Opportunity Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity. For questions, please email careersnoridian.com. This job posting will be closed 11/19/2018 at 8:00AM CST. No further applications will be considered.
Keywords: Noridian Healthcare Solutions, South Bend , Provider Auditor II, Accounting, Auditing , Chicago, Indiana
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