The Provider Auditor position is responsible for full or limited audits and interim rate reviews for hospitals, skilled nursing facilities, and clinics as both a preparer and reviewer of work product.
ESSENTIAL DUTIES & RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
• Performs limited or full audits of cost reports for hospitals, skilled nursing facilities, renal dialysis clinics, federally qualified health centers or rural health clinics that receive Medicare reimbursement.
• May perform tentative settlements on submitted cost reports or analyze the cost report to update the health care facility’s interim payment rate amount and determine any potential adjustment to payments.
• Generates and customizes all required internal and external correspondence and checklists to facilitate implementation of, and evidence of, completion of the audits.
• Coordinates with the Senior and/or In-Charge auditor in performing hospital audits. Performs post audit activities including follow-up with provider representatives.
• May be responsible for a number of special project, as deemed necessary, including continuous improvement projects and assisting team manager with other functions.
• Attends entrance and exit conferences and advises health care providers on Medicare policy questions as needed.
Performs other duties as the supervisor may, from time to time, deem necessary .
REQUIRED QUALIFICATIONS:
Bachelor’s/Master’s degree with a concentration/major in Accounting or Finance. Bachelor’s/Master’s degree in other fields can qualify if the candidate has 15 or more credit hours in specific Accounting or Finance classes .
PREFERRED QUALIFICATIONS:
Bachelor’s/Master degree in Accounting or Finance
MBA
CPA
"We are an Equal Opportunity Employer/Protected Veteran/Disabled"
The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.