[Hiring] Senior Auditor @GuideWell Source

Role Description

The Provider Audit and Reimbursement Senior Auditor 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, interim rate review/reimbursement, and 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.

Qualifications

• Bachelors' degree or a combination of education and experience in disciplines such as 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 years of Medicare cost report auditing experience.
• Demonstrated oral and written communications skills.
• Demonstrated ability to exercise independent judgement and discretion.
• Demonstrated attention to detail.

Requirements

• A Uniform Desk Review (UDR) and an audit for a large or complex hospital, as the in-charge auditor.
• A review of Medicare Bad Debts, inclusive of all relevant sample selection and relevant testing according to CMS standards.
• A review of DSH, inclusive of all relevant sample selection and relevant testing according to CMS standards.
• A review of IME/GME, inclusive of reviewing rotation schedules, bed count and all relevant testing according to CMS standards.
• A review and appropriate approval of an audit's scope.
• A supervisory review of certain provider types (may vary by team).
• Sample testing, transferring of testing to the audit adjustment report, and explaining the adjustments to a provider with the achievement of understanding by the provider.
• Ability to prepare workpapers according to CMS standards.
• Good working knowledge of all applicable software applications.
• Ability to serve as an effective mentor for less experienced staff.
• Engagement, commitment to departmental success, and professionalism.

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.