PARD Auditor - First Coast

GuideWell Source • Remote, OH

8d

About The Position

The Provider Audit and Reimbursement Auditor (PARD) can perform desk review/audit and interim rate review work. The position analyzes 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. It performs limited and full desk reviews of cost reports for providers receiving Medicare reimbursement and assists senior staff with hospital audits.

The role may also handle special projects and departmental administrative functions, attend entrance and exit conferences, and advise healthcare providers on Medicare policy questions as needed. This opportunity is open to remote work in approved states; in Florida and Pennsylvania, in-office and hybrid work may also be available.

Requirements

• Bachelor's degree, or a combination of education and experience in auditing, accounting, analytics, finance, or similar experience in lieu of a degree.
• Demonstrated oral, written, and interpersonal communication skills.
• Computer skills, including knowledge of Microsoft Office, Excel, Word, Outlook, and PowerPoint.
• Applicants may be required by the Federal Government and CMS to have lived in the United States for at least three of the last five years.
• Must undergo pre-employment background investigation, drug screening, and identity proofing; continued employment is contingent on satisfying applicable government screening requirements.
• Must have access to current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents.

Responsibilities

• Analyze cost reports and provider statistical and reimbursement report information to determine tentative settlements for SNFs, ESRDs, FQHCs/RHCs, bad debt payments, and other pass-through costs; update pass-through payment amounts and determine lump-sum adjustments for interim rate accuracy.
• Perform limited and full desk reviews of cost reports for SNFs, ESRDs, FQHCs/RHCs, and hospitals receiving Medicare reimbursement; prepare required correspondence and checklists documenting review completion.
• Coordinate with the Senior and/or In-Charge auditor on hospital audits; perform post-audit follow-up with provider representatives and prepare final cost report packages.
• Work on special projects, which may include IRIS data, HCRIS transmissions, wage index submissions, STAR updates, HFS cost report software, SNF pass-through logs, and PS&R backup.
• Assist management with departmental administrative functions, including maintaining electronic and hard-copy provider cost report files and participating in continuous improvement projects.
• Attend entrance and exit conferences and advise healthcare providers on Medicare policy questions as needed.
• Perform 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 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