Provider Auditor II

Noridian Healthcare Solutions, LLC•Fargo, ND

8d•$52,120 - $78,866•Remote

About The Position

The Provider Auditor is responsible for conducting Centers for Medicare & Medicaid Services (CMS) and other financial analysis, limited and full desk reviews, and in-house and on-site field audits to ensure proper reimbursement for health care providers for the Medicare programs. These positions are the face of Noridian interacting with providers/facilities management through the audit process which requires an advanced level of professionalism. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits.

Requirements

Bachelor's degree in Accounting, Business, Finance or equivalent work experience
1-year Medicare auditing experience
Knowledge of accounting theory and practices
Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint)
Demonstrated knowledge of Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software)

Nice To Haves

Bachelor's degree in Accounting, Business or Finance
Excellent written and verbal communication skills
Excellent organizational skills

Responsibilities

Requires an intermediate level of working knowledge of Medicare rules, regulations (e.g., Code of Federal Regulations, Provider Reimbursement manual) to ensure reimbursement principles are properly applied to the Medicare Cost Report so that Medicare reimbursement is accurate
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and positive feedback
Identifies areas of opportunity, provides solutions and works towards implementation and/or training, documenting the updates and procedures for efficiency and process improvement
Provides support and input for specialized and in-depth projects with increased complexity
Resolves cost report reopening requests as assigned, reviewing documentation submitted to determine accuracy of the request and proposing applicable adjustments to the cost report
Works with externally facing provider representatives when necessary to resolve appeal cases, including writing position papers and auditing documents
Possesses ability to Lead basic audits
Requires advanced knowledge of documentation requirements from audit testing through preparation of audit workpapers
Must obtain a minimum of 80 CET hours every two years.