Senior Provider Auditor

Noridian Healthcare Solutions, LLC; United States; Remote; USD 60,000 - 99,000; Full time

Benefits offered by this job

Health, Dental and Vision Insurance

401k and Company Match

Paid Holidays

Education Assistance Program

Paid Sick Leave

Job summary

Noridian Healthcare Solutions, LLC is seeking a Senior Provider Auditor to conduct CMS and other financial audits, prepare reports, and interact with providers. The role requires deep knowledge of Medicare rules and strong professionalism.

You will mentor staff, train on desk reviews and audit methodologies, and contribute to a robust compliance program while ensuring accurate reimbursements.

Qualifications

• Bachelor's degree in Accounting, Business, Finance or equivalent experience.
• 3 years Medicare auditing experience.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint).
• Advanced knowledge of Medicare rules and regulations for Medicare Cost Report accuracy.

Responsibilities

• Conduct CMS and other financial audits and reviews.
• Mentor staff and provide coaching.
• Train staff on audit methodologies and procedures.
• Provide guidance to senior auditors to ensure quality control.
• Maintain professional relationships with providers.
• Ensure documentation and audit workpapers are thorough.

Skills

Medicare auditing

Accounting knowledge

Proficiency in analysis

Education

Bachelor's degree in Accounting, Business, Finance

Tools

Microsoft Office Suite

Job description

* Position is Eligible for Remote / Work from Home Opportunity*

As a condition of employment, physical work location must be in one of the 50 states or the District of Columbia.

Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian (noridiansolutions.com)

Job Title

Senior Provider Auditor

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. These positions are the face of Noridian interacting with providers/facilities management through the audit process which requires an advanced level of professionalism. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits.

Key Duties/Responsibilities/Accountabilities

• Possesses and maintains a high level of working knowledge in Medicare rules, regulations (e.g, Code of Federal regulations, Provider reimbursement Manual) to ensure reimbursement principles are properly applied to the Medicare Cost Report so that Medicare reimbursement is accurate.
• Mentors staff at all levels by training, coaching, and providing constructive and positive feedback.
• Assists with new and existing employee training on department techniques, desk review and audit methodologies, policies and procedures.
• Provides professional judgement, strategic insight, and guidance to Provider Auditor I and II’s using their knowledge, experience, and research to ensure quality control is adequate and minimize risk for the team and organization.
• Performs less complex supervisory level reviews and coaches staff with feedback to strengthen their knowledge and skills to perform job functions effectively and efficiently.
• Enhances and maintains strong, professional working relationships with providers.
• Requires extensive knowledge of documentation requirements from audit testing through preparation of audit workpapers.
• Provides training to internal staff and participates in external outreach and education to the provider community.
• Must obtain a minimum of 80 CET hours every two years.

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 rules, regulations (e.g., Code of Federal Regulations, Provider Reimbursement Manual) to ensure the reimbursement principles are properly applied to the Medicare Cost Report so that Medicare reimbursement is accurate.

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

Total Rewards Package:

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency-specific regulations and federal contract requirements, and (ii) eligibility to obtain and maintain federal identity credentials and authorized access to government facilities, information systems, networks, sensitive information, or applications.

To obtain federal identity credentials and authorized access, employees in this position may be required, as a condition of employment, to successfully complete federal identity verification, federal background investigation and adjudication, credentialing, and access authorization processes in accordance with applicable federal requirements. Federal identity credentials and authorized access will not be issued to candidates who have not resided in the United States at least three (3) out of the last five (5) years.

Failure to obtain and maintain eligibility for required federal credentials and access authorization may result in removal from the position or termination of employment.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

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)

Below is the salary range for potential new hires.

Salary Range: The pay range for this position is $59,937.84 – $98,582.59 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Other Compensation: Incentive Plan & Lifestyle Benefit