[Hiring] Audit Associate @GuideWell Source

Role Description

The PARD Audit Associate 2 is responsible for supporting the Provider Audit and Reimbursement team by completing tentative settlements and desk reviews on Skilled Nursing Facilities (SNF), End Stage Renal Disease (ESRD) and Federally Qualified Health Centers/Rural Health Clinics (FQHC/RHC) providers.

• Reviews cost report and Provider Statistical and Reimbursement report (PS&R) information to determine accurate and timely SNF, ESRD and FQHC/RHC tentative settlements of bad debt payments or other pass-through costs. Reviews the cost report and accompanying bad debt logs to update pass-through payment amounts and determines lump-sum adjustments for interim rate accuracy. (40%)
• Performs limited desk reviews of cost reports for SNF, ESRD, FQHC/RHC, and Balance Budget Act (BBA), BBA ESRD reviews for providers that receive Medicare reimbursement. Generates all required internal and external correspondence and checklists to facilitate implementation of and evidence of completion of the desk reviews. (35%)
• Serves as a specialist over one or more various projects that could include duplicate interns and residents (IRIS) data, system for tracking audit and reimbursement (STAR) updates, including the tracking of providers, cost reports and continuing education and training (CET), Health Financial Systems (HFS) cost report software, SNF pass through logs, and PS&R backup. (15%)
• Assists management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report files, completing reconciliation reports, participating in continuous improvement projects, etc. (10%)
• Performs other duties as the supervisor may, from time to time, deem necessary.

Qualifications

• High School Diploma or GED
• 4 years' related experience in one or more of the following: Medicare cost reporting, finance, accounting, healthcare accounting, auditing or reimbursement

Requirements

• Associate degree in Accounting or related field (Preferred)
• Two years' experience in Medicare cost reporting (Preferred)
• Experience using HFS cost report software (Preferred)

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