Audit & Reimbursement III and Senior

Audit & Reimbursement III

Location:

This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

As an Audit & Reimbursement III, you will support our Medicare Administrative Contract (MAC) with the federal government. Under guided supervision, you will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement, participate in contractual audit and reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry.

• Analyze and interpret data and make recommendations for change based on judgment and experience.
• Work independently on assignments and under minimal guidance from the manager.
• Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.
• Gain experience with applicable Federal Laws, regulations, policies and audit procedures.
• Respond timely and accurately to customer inquiries.
• Multi‑task while independently and effectively prioritizing work using time management, initiative, project management and problem‑solving skills.
• Perform all duties of lower‑level positions as directed by management.
• Participate in special projects and review of work done by auditors as assigned.
• Assist in mentoring less experienced associates as assigned.
• Perform complex cost report desk reviews.
• Perform complex cost report audits, serving as an in‑charge auditor assisting other auditors assigned to the audit.
• Dependent upon experience, perform supervisory review of work completed by other associates.
• Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records.
• Perform cost report acceptance, interim rate reviews, final settlements and tentative settlements as assigned.
• Perform complex calculations related to payment exception requests and review exception request work papers prepared by others.
• Perform cost report reopenings.
• Under guided supervision, participate in completing more complex appeals related work:
  • Position papers
  • Jurisdictional reviews
  • Maintaining accurate records by updating all logs, case files, tracking systems
• Participate in all team meetings, staff meetings, and training sessions.

• Requires a BA/BS degree and a minimum of 3 years of audit/reimbursement or related Medicare experience; or any combination of education and experience that provides an equivalent background.
• This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign‑national applicants to meet the residency requirement of living in the United States at least three of the past five years.

• Degree in Accounting preferred.
• Knowledge of CMS program regulations and cost report format preferred.
• Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
• MBA, CPA or CIA preferred.
• Must obtain Continuing Education Training requirements (where required).
• Valid driver's license and the ability to travel may be required.

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions.

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