Provider Auditor I

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Provider Auditor I

The Provider Auditor is responsible for conducting Centers for Medicare & Medicaid Services (CMS) and other financial analysis, limited and full desk reviews, and in-house and on-site field audits to ensure proper reimbursement for health care providers for the Medicare programs. These positions are the face of Noridian interacting with providers/facilities management through the audit process which requires an advanced level of professionalism. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits.

• Initiates, plans, conducts, and finalize audits of financial, management, and administrative procedures of assigned cost reports. Responsible for determining appropriate scope and procedures for each individual review. Analyzes audit program to determine proper procedures are performed based on scope.
• Provides independent judgement and decisions regarding reviews and minimizes risk for organization and quality control.
• Participates in and facilitiates meetings, entrance conferences, walkthroughs and exit conferences with external providers.
• Requires ability to develop knowledge of documentation requirements from audit testing through preparation of audit workpapers.
• Possesses excellent written and verbal communication skills needed to draft, deliver, and issue corrective action plans for audit adjustment reports to consultants, CPA firms, management and provider executives.
• Performs risk analysis on provider financial statements to determine impact of potential risk of Medicare dollars.
• Must obtain a minimum of 80 CET hours every two years.
• Provides proactive support and process improvement by participating in special projects, documenting work as prescribed by the project. Collaborates with internal and external customers to determine and distribute requested information and documentation.

• Other duties as assigned

• Bachelor's degree in Accounting, Business, Finance or equivalent work experience
• Knowledge of accounting theory and practices
• Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint)

• Bachelor's degree in Accounting, Business or Finance
• Excellent written and verbal communication skills
• Excellent organizational skills

• Office Environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone use
• Requires the use of office equipment such as computer terminals, telephones, copiers and printers
• Infrequent lifting to 15 pounds
• Infrequent stooping

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

An employee in this position may be required to possess a "Federal Identification Card" (Federal ID) as a condition of employment. Federal ID's may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Below is the salary range for potential new hires.

Salary Range: $21.19 - $36.04

Other Compensation: Incentive Plan

Lifestyle Benefit: $50/month

This job will be closed 04/02/2025 at 8:00AM CST. No further applications will be considered.