Senior Provider Auditor

Noridian Healthcare Solutions, LLC•Fargo, ND

6d•$59,938 - $98,583•Remote

About The Position

The Senior Provider Auditor conducts Centers for Medicare & Medicaid Services (CMS) and other financial analyses, limited and full desk reviews, and in-house and on-site field audits to help ensure health care providers are properly reimbursed under Medicare programs. The role interacts professionally with providers and facility management throughout the audit process. It reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares and submits audit reports. The position requires extensive knowledge of Medicare rules and regulations, reimbursement principles, documentation requirements, audit testing, and audit workpapers. The Senior Provider Auditor also mentors and trains colleagues, provides guidance and quality-control support to Provider Auditor I and II staff, builds professional relationships with providers, and participates in provider education and outreach. The role is eligible for remote work, but the employee's physical work location must be in one of the 50 states or the District of Columbia.

Requirements

Bachelor's degree in Accounting, Business, Finance, or equivalent work experience.
At least 3 years of Medicare auditing experience.
Knowledge of accounting theory and practices.
Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, and PowerPoint.
Advanced knowledge of Medicare rules and regulations, including the Code of Federal Regulations and Provider Reimbursement Manual, and their application to Medicare Cost Reports.

Nice To Haves

Bachelor's degree in Accounting, Business, or Finance.
Excellent written and verbal communication skills.
Excellent organizational skills.
Ability to coach, advise, and develop others.
Demonstrated understanding of industry and enterprise objectives.
Excellent presentation skills.

Responsibilities

Conduct CMS and other financial analyses, limited and full desk reviews, and in-house and on-site field audits.
Review assigned portions of audit programs and determine compliance with policies and procedures.
Recommend corrective action plans and prepare and submit reports on audit results.
Maintain working knowledge of Medicare rules and regulations to ensure reimbursement principles are correctly applied to Medicare Cost Reports.
Mentor staff at all levels through training, coaching, and constructive feedback.
Assist with training new and existing employees on department techniques, desk review and audit methodologies, policies, and procedures.
Provide professional judgment, strategic insight, and guidance to Provider Auditor I and II staff, supporting quality control and risk reduction.
Perform less complex supervisory-level reviews and coach staff to strengthen their knowledge and job skills.
Build and maintain strong, professional working relationships with providers.
Apply knowledge of documentation requirements from audit testing through preparation of audit workpapers.
Train internal staff and participate in external outreach and education for the provider community.
Obtain at least 80 CET hours every two years.
Perform other duties as assigned.