PARD Auditor - Novitas

GuideWell Source

4h • Remote

About The Position

Are you interested in joining a team of experienced healthcare experts and have
the ability to shape and transform the healthcare delivery system? At our family
of companies, everything we do is to help improve the lives of the nearly 12
million Medicare beneficiaries we serve and 700,000 health care providers who
care for them. It is our goal to help create a better health experience for all
consumers. Join our winning culture and help transform Medicare for the millions
of people who rely on its services.

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.

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

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. (30%)
• 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. (30%)
• 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. (15%)
• 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. (10%)
• 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. (5%)
• Attends entrance and exit conferences and advises healthcare providers on Medicare policy questions as needed. (5%)
• Performs other duties as the supervisor may deem necessary (5%)

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: Entry Level