PARD Auditor - Novitas Solutions

GuideWell Source

1d • Remote

About The Position

The Provider Audit and Reimbursement Auditor (PARD) position can fill two primary roles -- desk review/audit, and interim rate review. Incumbents analyze cost reports and provider statistical and reimbursement report information to determine accurate and timely tentative settlements of bad debt payments or other pass-through costs; perform limited and full desk reviews of cost reports for providers that receive Medicare reimbursement and assist senior staff who perform hospital audits. Novitas Solutions is a family of companies focused on improving the lives of Medicare beneficiaries and healthcare providers, aiming to create a better health experience for all consumers.

Requirements

• Bachelors' degree or a combination of education and experience in disciplines such as auditing, accounting, analytics, finance or similar experience in lieu of a degree
• Demonstrated oral, written and interpersonal communications skills
• Computer skills including knowledge of Microsoft office suite, Excel, Word, Outlook and PowerPoint
• Must have lived in the United States for a minimum of three (3) years out of the last five (5) years.
• Must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing.
• Must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents.

Nice To Haves

• N/A

Responsibilities

• Analyzes cost report and provider statistical and reimbursement report (PS&R) information to determine accurate and timely Skilled Nursing Facility (SNF), End Stage Renal Disease (ESRD) and Federally Qualified Health Centers (FQHC)/Rural Health Clinics (RHC) tentative settlements of bad debt payments or other pass-through costs. Analyzes the cost report and accompanying bad debt logs to update pass-through payment amounts and determine lump-sum adjustments for interim rate accuracy.
• Performs limited and full desk reviews of cost reports for SNFs, ESRDs, FQHCs/RHCs providers and hospitals that receive Medicare reimbursement. Generates and customizes all required internal and external correspondence and checklists to facilitate implementation and evidence of the completion of the desk reviews.
• Coordinates with the Senior and/or In-Charge auditor in performing hospital audits. Performs post audit activities including follow-up with provider representatives and preparing the final cost report package.
• May be responsible for a number of special projects that could include duplicate interns and residents (IRIS) data, transmission of cost report information (HCRIS), wage index submissions, system for tracking audit and reimbursement (STAR) updates including the tracking of providers, cost reports and continuing education and training (CET), HFS cost report software, SNF pass through logs, and PS&R backup.
• Assists management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report files, participating in continuous improvement projects, etc.
• Attends entrance and exit conferences and advises healthcare providers on Medicare policy questions as needed.
• Performs other duties as the supervisor may deem necessary.

Benefits

• Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
• Short- and long-term disability benefits
• 401(k) plan with company match and immediate vesting
• Free telehealth benefits
• Free gym memberships
• Employee Incentive Plan
• Employee Assistance Program
• Rewards and Recognition Programs
• Paid Time Off and Paid Sick Leave

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level