PARD Audit Assoc 2-Novitas

SUMMARY STATEMENT
The PARD Audit Associate 2 is responsible for supporting the Provider Audit and Reimbursement team by completing tentative settlements and desk reviews on Skilled Nursing Facilities (SNF), End Stage Renal Disease (ESRD) and Federally Qualified Health Centers/Rural Health Clinics (FQHC/RHC) providers.

ESSENTIAL RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.

Reviews cost report and Provider Statistical and Reimbursement report (PS&R) information to determine accurate and timely SNF, ESRD and FQHC)/ (RHC) tentative settlements of bad debt payments or other pass-through costs. Reviews the cost report and accompanying bad debt logs to update pass-through payment amounts and determines lump-sum adjustments for interim rate accuracy. (40%)

Performs limited desk reviews of cost reports for SNF, ESRD, FQHC/RHC, and Balance Budget Act (BBA), BBA ESRD reviews for providers that receive Medicare reimbursement. Generates all required internal and external correspondence and checklists to facilitate implementation of and evidence of completion of the desk reviews. (35%)

Serves as a specialist over one or more various projects that could include duplicate interns and residents (IRIS) data, system for tracking audit and reimbursement (STAR) updates, including the tracking of providers, cost reports and continuing education and training (CET), Health Financial Systems (HFS) cost report software, SNF pass through logs, and PS&R backup. (15%)

Assists management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report files, completing reconciliation reports, participating in continuous improvement projects, etc. (10%)

Performs other duties as the supervisor may, from time to time, deem necessary.

 

REQUIRED QUALIFICATIONS
* High School Diploma or GED
* 4 years' related experience in one or more of the following: Medicare cost reporting, finance, accounting, healthcare accounting, auditing or reimbursement

 

PREFERRED QUALIFICATIONS
* Associate degree in Accounting or related field
* Two years' experience in Medicare cost reporting
* Experience using HFS cost report software

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.