[Hiring] PARD Auditor @GuideWell Source

Role Description

The Provider Audit and Reimbursement Auditor (PARD) position can fill two primary roles -- desk review/audit, and interim rate review. Incumbents analyze cost reports and provider statistical and reimbursement report information to determine accurate and timely tentative settlements of bad debt payments or other pass-through costs; perform limited and full desk reviews of cost reports for providers that receive Medicare reimbursement and assist senior staff who perform hospital audits.

Essential Duties & Responsibilities

• Analyzes cost report and provider statistical and reimbursement report (PS&R) information to determine accurate and timely Skilled Nursing Facility (SNF), End Stage Renal Disease (ESRD) and Federally Qualified Health Centers (FQHC)/Rural Health Clinics (RHC) tentative settlements of bad debt payments or other pass-through costs.
• Performs limited and full desk reviews of cost reports for SNFs, ESRDs, FQHCs/RHCs providers and hospitals that receive Medicare reimbursement.
• Coordinates with the Senior and/or In-Charge auditor in performing hospital audits.
• May be responsible for a number of special projects that could include duplicate interns and residents (IRIS) data, transmission of cost report information (HCRIS), wage index submissions, and system for tracking audit and reimbursement (STAR) updates.
• Assists management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report files.
• Attends entrance and exit conferences and advises healthcare providers on Medicare policy questions as needed.
• Performs other duties as the supervisor may deem necessary.

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.
• Demonstrated oral, written and interpersonal communications skills.
• Computer skills including knowledge of Microsoft office suite, Excel, Word, Outlook and PowerPoint.

Requirements

• The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company.
• Background Investigation: If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire.
• Identity Documentation: You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents.

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.

Company Description

Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.