PARD Audit Assoc 1 - Novitas

Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.

Benefits info:
* Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
* Short- and long-term disability benefits
* 401(k) plan with company match and immediate vesting
* Free telehealth benefits
* Free gym memberships
* Employee Incentive Plan
* Employee Assistance Program
* Rewards and Recognition Programs
* Paid Time Off and Paid Sick Leave

SUMMARY STATEMENT
The PARD Audit Associate 1 is primarily responsible for assisting the PARD Auditors, or in completing limited desk reviews of cost reports or assist PARD Reimbursement Auditors in completing interim rate reviews for all type of providers and other administrative functions for all three contracts.

ESSENTIAL DUTIES & 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.
* Performs limited desk reviews of cost reports for Skilled Nursing Facilities (SNF's), End Stage Renal Disease (ESRDs), Federally Qualified Health Clinics (FQHCs), or Rural Health Clinics (RHCs). The work performed on these provider types may be limited to the lowest-level of reimbursement and incumbents may only perform one provider type. May assist the PARD Auditors in performing limited desk reviews of cost reports for SNF's, ESRDs, FQHCs, or RHCs or assist the PARD Managers, and the Appeal Support Contractors (ASC) in defending the position of the MAC and CMS during the PRRB appeals process. Updates provider specific files for interim rate reviews and cost to charge calculations for all type of providers, including review of edits and determines if further review is needed by the reviewer. (30%)
* Coordinates, organizes and analyzes materials received from providers for desk reviews, ASCs and the PRRB. Assists in tie-ins and tie-outs process for all type of providers, including change of ownership, creation of welcome letters and Fiscal Intermediary Standard System (FISS) updates for initial rates. (30%)
* Corresponds with providers regarding desk reviews and other MACs; responsible for appeal file creation, maintenance and closure and jurisdictional research and drafting of documents as needed. Assists in the Provider Statistical and Reimbursement (PS&R) process for both detail and summary requests and monitoring mail for provider correspondence. (20%)
* Assists management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report appeal files, participating in continuous improvement projects, etc. Assists Reimbursement auditors in other administrative functions of interim rate reviews, including manual creation of notification letters, emailing documents, and annual system payment updates. (15%)
* Performs other duties as deemed necessary. (5%)

REQUIRED QUALIFICATIONS
* High School Diploma or GED
* 2 years' related work experience, including accounting, audit or reimbursement
* Experience utilizing PC with standard applications, report writers and/or query tools such as Microsoft Word, Excel

PREFERRED QUALIFICATIONS
* Associate degree in Accounting Healthcare management, Accounting, Finance, Business Administration
* Medicare cost reporting experience

The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.

"We are an Equal Opportunity/Protected Veteran/Disabled Employer."

This opportunity is open to remote work in the following approved states: AL, FL, GA, ID, IN, IO, KS, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require additional approval. In FL and PA in-office and hybrid work may also be available.