The Lead Auditor performs desk reviews and audits of Medicare cost reports while overseeing the daily workload and training of the audit team. They ensure compliance with CMS regulations and internal quality standards while coordinating complex audit projects.
Respond to telephone and written inquiries from the Medicare provider community regarding coverage guidelines, billing, and claims. Research and analyze complex claim issues, denials, and overpayments to provide accurate resolutions and education to customers.
The Senior Auditor performs desk reviews and audits of Medicare cost reports while ensuring compliance with CMS regulations and internal production goals. They also mentor junior staff, provide training on reimbursement principles, and manage complex payment methodology projects.
