[Hiring] Provider Audit and Reimbursement Lead Auditor @American Recruiting & Consulting Group

Role Description

The Provider Audit and Reimbursement Lead utilizes advanced knowledge of Medicare laws, regulations, instructions from the Centers for Medicare and Medicaid Services (CMS), and provider policies to perform desk reviews and audits of the annual Medicare cost reports, as well as interim rate review/reimbursement, and/or settlement acceptance/finalization for all provider types, including complex and organ transplant hospitals, as both a preparer and reviewer of work product based on established performance goals. The position will mentor and train Auditors and In-Charge Auditors and oversee daily workload of unit team.

Essential Duties & Responsibilities

• Lead Accountabilities (60%):
  • Coordinates with management by overseeing the unit's daily workload.
  • Routinely uses independent judgment and discretion to make decisions for self and less experienced auditors.
  • Prioritizes auditor work and ensures that audit work is completed on time.
  • Recognizes data needs for self and other auditors; develops plan of work for less experienced auditors.
  • Analyzes working papers and cost reports for errors.
  • Reviews workpapers of auditors for correctness, control and adherence to GAAP, GAAS, and GAS.
  • Reviews, evaluates and approves the disbursement of tentative cost settlements.
  • Develops technical competence and constructive work attitudes in self and less experienced auditors.
  • Coordinates the assignments and subsequent development of auditors based on their training needs.
  • Manages, implements and coordinates an internal quality control program.
  • Facilitates the development of Quality Management System (QMS) policies and procedures.
• Auditor Accountabilities (40%):
  • Performs audit functions including those which are non-routine.
  • Coordinates large audits and/or diverse audits independently.
  • Uses professional communication techniques in own and auditor's work.
  • Establishes and maintains constructive provider relations.
  • Conducts entrance and exit conferences and meetings away from office as needed.
  • Performs other duties as the manager may deem necessary.

Qualifications

• Bachelors' degree or a combination of education and experience in auditing, accounting, analytics, finance or similar experience in lieu of a degree.
• Thorough understanding of the Medicare cost report, including the step-down method.
• 2.5 to 3 years of Medicare cost report auditing experience.
• Experience as an in-charge auditor for a Uniform Desk Review (UDR) and an audit for a large or complex hospital.
• Experience with Medicare Bad Debts, DSH, IME/GME reviews, and audit scope approvals.
• Demonstrated leadership skills and ability to mentor junior auditors.
• Good working knowledge of applicable software applications.
• Demonstrated oral and written communications skills.
• Attention to detail and ability to exercise independent judgment and discretion.

Requirements

• This opportunity is open to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY.
• Specific counties and cities within these states may require further approval.
• In FL and PA in-office and hybrid work may also be available.

Benefits

• 100% remote work opportunity.
• Direct hire FTE position.
• Tremendous career growth potential.

Company Description

ARC Group is a Forbes-ranked top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We are committed to providing equal employment opportunities and fostering an inclusive work environment.