Audit & Reimbursement III and Senior

The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).

• Analyzes and interprets data and makes recommendations for change based on judgment and experience.
• Able to work independently on assignments and under minimal guidance from the manager.
• Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.
• Gain experience with applicable Federal Laws, regulations, policies and audit procedures.
• Respond timely and accurately to customer inquiries.
• Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills.
• Must be able to perform all duties of lower-level positions as directed by management.
• Participates in special projects and review of work done by auditors as assigned.
• Assist in mentoring less experienced associates as assigned.
• Perform complex cost report desk reviews.
• Perform complex cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit.
• Analyze and interpret data per a provider’s trial balance, financial statements, financial documents or other related healthcare records.
• Perform cost report acceptance, interim rate reviews, final settlements and tentative settlements as assigned.
• Performs complex calculations related to payment exception requests and reviews exception request work papers prepared by others.
• Perform cost report reopenings.
• Under guided supervision, participate in completing more complex appeals related work:
• Position papers
• Jurisdictional Reviews
• Maintaining accurate records by updating all logs, case files, tracking systems
• Participate in all team meetings, staff meetings, and training sessions

• Requires a BA/BS degree and a minimum of 3 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background.

• 401k matching
• Health insurance
• Flight privileges

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