New job Provider Auditor I in North Dakota

Provider Auditor I

Company : Noridian Healthcare Solutions
Salary : Details not provided
Location : North Dakota

Full Description

* Position is eligible for Remote / Work from Home opportunity *

Job Title

Provider Auditor I

Job Summary

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 audits to ensure proper reimbursement for health care providers for the Medicare programs.

Key Performance Indicators

  • Meets CMS standards while maintaining department performance expectations
  • Excellent attention to detail
  • Ability to prioritize and multi-task workload

Essential Functions

Key Duties/Responsibilities/Accountabilities

  • Develops a working knowledge of Medicare reimbursement principles and the Medicare Cost Report
  • Participates in the planning, organizing, and coordinating of the desk review process
  • Assists Provider Auditor II & Senior Provider Auditor with in-house and on-site field audits
  • Assists Provider Auditor II & Senior Provider Auditor with calculating limits and exceptions and completing wage index desk reviews
  • Develops and maintains a positive working relationship with providers

Non-Essential Duties and Functions

  • Other duties as assigned

Minimum Qualifications

  • Bachelor's degree in Accounting, Business, Finance or equivalent work experience
  • Knowledge of accounting theory and practices
  • Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint)

Preferred Qualifications

Above requirements and the following:

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

Environment and Cognitive/Physical Demands

  • Office Environment
  • Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
  • Requires prolonged sitting and telephone use
  • Requires the use of office equipment such as computer terminals, telephones, copiers and printers
  • Infrequent lifting to 15 pounds
  • Infrequent stooping

Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

Equal Employment Opportunity

Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.

Other Information

Job Posting Policy 6.05: New employees with Noridian Healthcare Solutions will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside their department, they must attain a minimum of six months of service before they can apply.

This job will be closed 04/26/2021 at 8:00AM CST. No further applications will be considered.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor???s legal duty to furnish information. 41 CFR 60-1.35(c)

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