Senior Provider Auditor

Noridian Healthcare Solutions, LLC•Fargo, ND

8d•$59,938 - $90,696•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
3 years' Medicare auditing experience
Knowledge of accounting theory and practices
Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint)
Advanced knowledge of Medicare rules, regulations (e.g., Code of Federal Regulations, Provider Reimbursement Manual) to ensure the reimbursement principles are properly applied to the Medicare Cost Report so that Medicare reimbursement is accurate.

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

Possesses and maintains a high level of working knowledge in 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 staff at all levels by training, coaching, and providing constructive and positive feedback.
Assists with new and existing employee training on department techniques, desk review and audit methodologies, policies and procedures.
Provides professional judgement, strategic insight, and guidance to Provider Auditor I and II’s using their knowledge, experience, and research to ensure quality control is adequate and minimize risk for the team and organization.
Performs less complex supervisory level reviews and coaches staff with feedback to strengthen their knowledge and skills to perform job functions effectively and efficiently.
Enhances and maintains strong, professional working relationships with providers.
Requires extensive knowledge of documentation requirements from audit testing through preparation of audit workpapers.
Provides training to internal staff and participates in external outreach and education to the provider community.
Must obtain a minimum of 80 CET hours every two years.