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Senior Provider Auditor

Company: Noridian Healthcare Solutions, LLC
Location: Fargo
Posted on: April 9, 2021

Job Description:

If you are a job seeker with a disability and require a reasonable accommodation to apply for one of our jobs, you will find the contact information to request the appropriate accommodation by visiting the following page: * Position is eligible for Remote / Work from Home opportunity * Job Title Senior Provider Auditor Job Summary The Provider Auditor is responsible for conducting Centers for Medicare & Medicaid Services (CMS) and other financial analysis and cost report re-openings to ensure proper reimbursement for health care providers for the Medicare programs. Key Performance Indicators

  • Meets CMS standards while maintaining department performance expectations
  • Excellent attention to detail
  • Ability to prioritize and multi-task workload Essential Functions 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 reopening process
    • Enhances and maintains strong, professional working--relationship with providers
    • Possesses and maintains a high 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
    • Provides strategic insight and guidance to Provider Auditors using their knowledge, experience, and research
    • Performs reviews on Auditor I & II work and corrects errors and omissions by department staff
    • Provides independent judgement and decisions regarding reviews and minimizes risk for the organization by providing quality control
    • May lead smaller projects
    • May serve as team lead to ensure projects completed on time, on scope, and on budget Non-Essential Duties and Functions
      • Other duties as assigned Minimum Qualifications
        • Bachelor's degree in Accounting, Business, Finance or equivalent work experience
        • 3 years' Medicare auditing experience
        • Knowledge of accounting theory and practices
        • Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint)
        • Advanced knowledge of Medicare/Medicaid reimbursement principles and regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software) Preferred Qualifications Above requirements and the following:
          • Bachelor's degree in Accounting, Business or Finance
          • Excellent written and verbal communication skills
          • Excellent organizational skills
          • Ability to coach, advise, and develop others
          • Demonstrated understanding of industry and enterprise objectives
          • Excellent presentation skills Environment and Cognitive/Physical Demands
            • Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
            • Requires prolonged sitting and telephone use
            • Requires the use of office equipment such as computer terminals, telephones, copiers and printers
            • Infrequent lifting to 15 pounds
            • Infrequent stooping 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 management. CMS Access Compliance and Regulation Contingency Statement Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card. Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.-- 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 their department, they must attain a minimum of six months of service before they can apply.-- This job will be closed 3/26/2021 at 8:00AM CST. No further applications will be considered.-- Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: Noridian Healthcare Solutions, LLC, Fargo , Senior Provider Auditor, Accounting, Auditing , Fargo, North Dakota

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