Medicare Cost Report Auditor III

Summary

Responsible for providing a full range of financial, compliance, and operational audits, business advisory, and consultation services, investigations, internal controls, accountability, and use of resources.

• Conduct internal and/or external timely operational, financial, and/or compliance audits of divisions, departments, providers, and activities of the corporation including evaluation of internal controls. Identify, document, and evaluate business risks. Develop written audit programs. Conduct testing and analysis of existing controls to determine adequacy and effectiveness. Prepare written work papers to document testing results and conclusions reached. Document issues, the causes of those issues, and their effects on the process/function and the corporation.
  
  Serve as Lead Auditor on more complex audit assignments.
• Draft recommendations to limit risks and improve processes, functions and activities. Write audit reports for corporate executive management that clearly and effectively convey engagement evaluations, conclusions and recommendations. Collect and analyze data to detect deficient controls, duplicated effort, fraud, or non‑compliance with laws, regulations, and management policies. Conduct testing of corrective actions as identified.
• Develop detailed reports on each audit conducted. Reports include a review of findings and an identification of recommendation to correct any deficiencies and methods for improvement to processes. Examine and evaluate financial and information systems, recommending controls to ensure system reliability and data integrity.
• Conduct special audit studies for management, such as those required to discover controls for prevention of fraud. Prepare reports of findings and recommendations for management.
• Provide training to and assist or lead other auditors in completing their assignments as a means of maximizing audit efficiency and thus reducing lost time and involvement of corporate personnel.
• Strive to expand knowledge of applicable laws, regulations, program instructions, and technology through self‑study, corporate offerings, and formal training programs.

• Required
  
  Education:
  
  Bachelor’s in a job‑related field.
• Required Experience: 5 years auditing experience.
• Required
  
  Skills and Abilities:
  
  
  • Knowledge of the principles and practices of auditing.
  • Ability to analyze and determine the applicability of financial data, to draw conclusions and make appropriate recommendations.
  • Ability to gather information by examining records and documents and to interview individuals concerning those records.
  • Strong interpersonal skills and the ability to work professionally with persons at all levels, and to maintain effective working relationships.
  • Ability to communicate clearly and effectively in oral and written form.
  • Ability to handle sensitive matters on a confidential basis.
  • Excellent analytical or critical thinking and problem‑solving capabilities.
• Required Software and Tools: Microsoft Office.
• Preferred Education: Bachelor’s in Accounting/Finance or 12 credit hours.
• Preferred Experience:
  • Lead auditor for Uniform Desk Reviews (UDRs) and complex hospital audits.
  • Minimum 2 years of Medicare hospital cost report auditing experience.
  • Expertise in Medicare Bad Debt and DSH cost report reviews, including sample selection and CMS‑compliant testing.
  • Skilled in Nursing and Allied Health Education (NAHE) legal operator determinations and add‑on payment calculations.
• Preferred Licenses and Certificates: Certified Internal Auditor (CIA), Certified Public Accountant (CPA), or Certified Information Systems Auditor (CISA).
• Work Environment: Typical office environment. Travel between office buildings and out of town may be required.

• Subsidized health plans, dental and vision coverage
• 401(k) retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On‑site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

Blue Cross Blue Shield of South Carolina and our subsidiary companies maintain a continuing policy of…