Audit & Reimbursement III (US)

About the position

The Audit & Reimbursement III is responsible for completing limited and full desk reviews on teaching, organ acquisition hospitals and other complex provider cost reports. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Responsibilities

• Plans, directs and controls specific provider audits.
• In charge auditor on large and/or complex field audits.
• Responsible for assigning, reviewing, and approving the work performed by auditors on team audits.
• Responsible for completing interim rate reviews final settlements and tentative settlements as assigned.
• Will support the Appeal Unit with appeal issues as assigned.
• Participates in special projects and review of work done by lower level auditors as assigned.
• Performs complex calculations related to payment exception requests and reviews exception request workpapers prepared by others.
• Analyzes and interprets data and makes recommendations for change based on judgment and experience.
• May perform Part A provider enrollment responsibilities as needed.
• Associates in this role are expected to maintain continuing education requirements.

Requirements

• Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background.
• This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.

Nice-to-haves

• Degree in Accounting preferred.
• Knowledge of CMS program regulations and cost report format preferred.
• Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
• MBA, CPA or CIA preferred.
• A valid driver's license and the ability to travel to worksite and other locations as necessary.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
• Paid Time Off
• Medical, dental, vision benefits
• Short and long term disability benefits
• Life insurance
• Wellness programs
• Financial education resources