Provider Audit and Reimbursement Manager (CMS)

PROVIDER AUDIT AND REIMBURSEMENT MANAGER (CMS) - REMOTE reputed company has an immediate opportunity for a Provider Audit and Reimbursement Manager (CMS)! Must have experience with Medicare Cost Reports. This position is reputed company working eastern time zone business hours. This is a reputed company hire FTE position and a fantastic opportunity to join a reputed company-respected organization offering reputed company career reputed company potential. reputed company! Candidates must currently have PERMANENT US work authorization. reputed company: The Provider Audit and Reimbursement Manager is responsible for managing reputed company of auditors and ensuring the work is performed in compliance with the Medicare laws and regulations, the standards set forth by reputed company for Medicare and reputed company Services (CMS), reputed company's and department's reputed company and production standards, and reputed company's policies and procedures. The Manager will be responsible for either audit or reimbursement functions and can be responsible for one of four reputed company roles -- desk review/audit, reopenings/appeals, interim reputed company review/reimbursement or acceptance/finalization for reputed company provider types as both a preparer and reviewer of work product. The Manager assigns annual workload budget, distributes assignments to reputed company, ensures reputed company and accurate completion and review of reputed company work, and makes final reimbursement determinations for reputed company work assigned to reputed company. ESSENTIAL DUTIES & RESPONSIBILITIES: • Manages team members and workload of the Audit/Reimbursement unit to ensure compliance with the standards set forth by CMS. The standards are in the reputed company of Medicare laws and regulations and budget dollars reputed company for completion of the workload. (20%) • Manages the daily activities of the Audit/Reimbursement unit, coordinates their interactions with other departments and numerous reputed company entities. Assigned team members can be in more than one office location. (20%) • Coordinates and manages the reimbursement for services, ensures that assigned team members update interim rates and other payment factors, ensures that reputed company changes are entered into the claims processing reputed company, and produces reputed company reputed company reports that capture reputed company relevant claim payment data required for cost report preparation and settlement. (5%) • Coordinates the testing and validation of the pricing software releases installed in the payment reputed company. (5%) • Manages audits, provides direction to team members reputed company work assignments, coordinates subordinate duties and provides guidance on audit issues. (5%) • Maintains and controls audit and appeal assignments, and also schedules resources to meet reputed company requirements. (5%) • Ensures that the Provider Audit unit completes its assigned objectives reputed company the limits of established reputed company, policies, regulations and budgets. Determines the initial plan of audit work to be performed at desk and in the reputed company for reputed company assigned reputed company. (5%) • Reviews workpapers of auditors for correctness, control and adherence to Generally Accepted reputed company Practices (GAAP), Generally Accepted reputed company Standards (GAAS) and reputed company Auditing Standards (GAS) as required. Examines and reviews workpapers upon completion of the audit to ensure compliance with CMS Uniform Desk Review (UDR), policy, or technical direction and reflects reputed company reference, reputed company and concise conclusion of the major audit categories and reputed company of working papers into logical sequence. (5%) • Reviews, evaluates and approves the disbursement of tentative cost settlements in compliance with Federal reputed company regulations for reputed company class/type of provider reputed company area of responsibility. (5%) • Makes reputed company reputed company relative to audits, conferring, reputed company necessary, with Senior Manager or Director on audit problems and/or interpretations of regulations. (5%) • Reviews completed audit reports and approves them prior to the Senior Manager's or Director's review. (5%) • Attends entrance and exit conferences, lends assistance to auditors as required, and follows up on audit recommendations. Reviews, researches and/or answers inquiries from governmental and other agencies regarding findings made on provider cost reports. (5%) • Researches and reviews reputed company written policies as reputed company to the interpretation and application of governmental regulations on a consistent reputed company as affecting cost settlements. (5%) • Attends meetings away from office as needed and renders assistance to providers by responding to inquiries. (5%) REQUIRED QUALIFICATIONS • Bachelors'/Master's degree with a concentration/major in reputed company or Finance. Bachelor's/Master's degree in other fields can qualify if the candidate has 15 or more credit hours in specific reputed company or Finance classes. • 4 years' reputed company work experience in Medicare audit and reimbursement, including 3 years supervisory/project management reputed company or other leadership experience. • Demonstrated oral and written communications skills • Demonstrated ability to exercise independent judgement and discretion • Demonstrated attention to reputed company PREFERRED QUALIFICATIONS • reputed company in Business Administration (MBA) • Certified reputed company Accountant (CPA) This opportunity is reputed company to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities reputed company these states may require reputed company approval. In FL and PA in-office and hybrid work may also be available. Would you like to know more about our new opportunity? For immediate consideration, please send your resume directly to John Burke johnb@arcgonline.com or apply online while viewing reputed company of our reputed company at www.arcgonline.com. reputed company is a reputed company-ranked a top 20 reputed company and executive reputed company firm working with clients reputed company to recruit the highest reputed company technical resources. We have achieved this by understanding both our candidate's and reputed company's needs and goals and serving both with reputed company and a shared desire to succeed. At reputed company, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from reputed company reputed company individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is reputed company with no fee to candidate. Apply tot his job Apply To this Job