[Hiring] Provider Auditor Intern @GuideWell Source

Role Description

As a Provider Auditor Intern, you will assist in reviewing cost reports from providers (hospitals, nursing homes, renal dialysis facilities, clinics, etc.) that received reimbursement for Medicare Services. Provider Auditor Intern activities may include exposure to settlement and/or audit functions by being trained to process the acceptability of annual Medicare cost reports, to accurately and timely process final settlement of less complex healthcare providers (non-hospitals), and by assisting experienced Auditors in preparing for audit engagement and in completion of Desk Reviews and Audits. Incumbents will receive formal training and regular exposure to leadership to gain meaningful insight into Provider Audit Department operations and responsibilities of an exempt Provider Auditor.

Essential Duties & Responsibilities

• Performs modified desk reviews and limited desk reviews of cost reports for SNF (Skilled Nursing Facilities), ESRD, and FQHC/RHC providers that receive Medicare reimbursement. Generates and customizes all required internal and external correspondence and checklists to facilitate implementation and evidence of the completion of the desk reviews. (45%)
• Assists PARD Auditors in completing Desk Reviews-Hospitals and S10 Audits-Hospitals by preparing and maintaining working papers, the form and content of which are designed to meet the circumstances of the particular Desk Review or S10 Audit assigned. Involves data input into working paper files, data preparation, and data gathering for further review. (30%)
• Processes Cost Report Acceptance of less complex healthcare providers including SNF, ESRD, CMHC, RHC, and Home Office cost statements which includes acceptance or rejection. May determine rejections but must be approved by Team Lead or above. (5%)
• Responsible for reviewing and interpreting cost reporting instructions, CMS instructions, and any Technical Direction Letter (TDLs) issued by CMS to make an informed decision on any discrepancies. Must gain high level staff approval. (5%)
• Assists PARD Auditors in preparing for engagements by preparing and maintaining working papers, the form and content of which are designed to meet the circumstances of the particular audit assigned. Involves data input into working paper files, data preparation, and data gathering for further review. (5%)
• Resolves discrepancies and may communicate with a variety of administrative and professional employees within and outside the organization. (5%)
• Performs other duties as the supervisor may, from time to time, deem necessary. (5%)

Qualifications

• Able to commit to working at least 30 hours a week
• Currently enrolled as a senior at an accredited college or university (full or part-time) in Accounting, Finance or related field and scheduled to have their degree conferred by the institution within the internship time period
• Knowledge of basic accounting principles and audit procedures
• A minimum 3.0 GPA
• Basic proficiency level with Microsoft Office applications such as Excel, Word, and Outlook
• Effective oral, written, and interpersonal communication skills
• Effective organization skills
• Ability to follow policies and procedures pertaining to company nonexempt employees -- e.g., adhering to time keeping standards

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. These years of residence do not have to be consecutive.
• 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. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment.
• 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. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards.

Benefits

• 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.