Jobs
>
Fargo

    Provider Audit Technical Reviewer - Fargo, United States - Noridian

    Noridian
    Noridian Fargo, United States

    1 week ago

    Default job background
    Description
    Provider Audit Technical Reviewer - REMOTE


    • Position is eligible for Remote / Work from Home opportunity


    The Provider Audit Reviewer is responsible for approving the audit scope determinations, conducting full reviews of the completed audits, high level desk reviews, special projects and ensures workloads are current and operating within Medicare, corporate, and departmental guidelines and budgets.

    Essential Functions
    Key Duties/Responsibilities/Accountabilities

    Meets contractual obligations and performance standards, while ensuring quality performance through the performance management of staff and implementing internal controls.

    Performs complex supervisory level reviews and coaches staff with feedback to strengthen their knowledge and skills to perform job functions effectively and efficiently.

    Prioritizes workload, ensuring workflow is monitored and adjusted as needed to ensure workloads are completed in a timely manner based on internal and external standards.

    Provides technical coaching and direction to ensure staff are meeting expectations in partnership with the applicable supervisor.
    Provides continuous updates to Audit Supervisor on staff's technical performance.
    Provides input during the disciplinary action process when appropriate to ensure employee performance meets expectations. Assists Audit Supervisor with follow up for disciplinary plans and documents conversations and decisions appropriately.
    Provides ideas and encourages innovation in areas of process improvements and technology enhancements.
    Leads by example by promoting teamwork, recognition, and leadership while demonstrating company values.
    Responds to and implements change in a flexible, positive manner.

    Participates as the area subject-matter expert and resource for internal and external customers, which may include CMS, government officials, provider representatives, and other various contractors.

    Collaborates with the training team to identify substantive training issues and develop curriculum.
    Serves as a resource point for internal and external customers including CMS and various contractors.

    Provides analytical and broad-based view of systems by acquiring and maintaining a thorough knowledge of all systems and subsystems used to administer the Medicare program and other lines of business.

    May conduct reviews of all departmental activities, including in-depth analysis of complex reimbursement structures identified in the Medicare cost report which are in accordance with

    CMS and the Code of Federal Regulations.
    Must obtain a minimum of 80 CET hours every two years.
    Non-Essential Duties and Functions
    Other duties as assigned
    Minimum Qualifications
    Bachelor's degree in accounting, business or finance
    Advanced knowledge of Medicare reimbursement principles and regulations and Medicare Cost Report
    Advanced knowledge of accounting theory and practices
    Proficient in Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software)
    Demonstrates an understanding of industry and enterprise objectives
    Demonstrates a technical understanding of systems, process and CMS and departmental guidelines
    Excellent written and verbal communication skills
    Ability to build effective interpersonal relationships within the workplace
    Ability to problem solve and develop technical problem-solving skills within staff
    Excellent organization skills and attention to detail
    Excellent presentation skills
    Preferred Qualifications

    Above requirements and the following:
    CPA or other professional certification
    Advanced Microsoft Office skills
    Possesses the ability to advise and educate others
    Strong analytical skills
    Advanced in Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software)
    Environment and Cognitive/Physical Demands

    Ability to read, hear, speak, keyboard, reason and problem solve
    Normal hearing and vision range
    Requires prolonged sitting and telephone usage
    Requires the use of office equipment such as computer terminals, telephones, copiers and printers
    Infrequent lifting up to 15 pounds
    Infrequent stooping
    Ability to travel
    Statement of Other Duties

    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.

    Segregation of Duties

    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.


    Total Rewards Package:


    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.

    CMS Access Compliance and Regulation Contingency Statement

    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.

    Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.

    Below is the salary range for potential new hires.

    Salary Range:
    $59,937 – $98,582 per year

    Other Compensation:
    Incentive Plan

    This job will be closed 4/12/2024 at 8:00AM CST. No further applications will be considered.
    Qualifications

    Education

    Preferred

    Bachelors or better in Accounting.
    Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

    The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.

    However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.

    41 CFR c)

    #J-18808-Ljbffr
  • NORIDIAN HEALTHCARE SOLUTIONS, LLC

    Provider Audit Technical Reviewer

    4 days ago

    NORIDIAN HEALTHCARE SOLUTIONS, LLC Fargo, United States

    Position is eligible for Remote / Work from Home opportunity * · Department: Provider Audit · Telecommuting Eligible: Yes · Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian ) · Job Title · Provider Audit T ...

  • NORIDIAN HEALTHCARE SOLUTIONS, LLC

    Provider Audit Technical Reviewer

    2 weeks ago

    NORIDIAN HEALTHCARE SOLUTIONS, LLC Fargo, United States

    Position is eligible for Remote / Work from Home opportunity * · Department: Provider Audit · Telecommuting Eligible: Yes · Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian ) · Job Title · Provider Au ...

  • Noridian Healthcare Solutions

    Provider Audit Technical Reviewer

    2 weeks ago

    Noridian Healthcare Solutions Fargo, United States Regular, Full time

    · * Position is eligible for Remote / Work from Home opportunity * · Department: Provider Audit · Telecommuting Eligible: Yes · Notice of Collection & Privacy Policy for Applicants Residing in California: · Job Title · Provider Audit Technical Reviewer · Job Summary · The Provi ...

  • BlueWave Solutions

    Technical Clerk

    2 weeks ago

    BlueWave Solutions West Fargo, ND, United States Freelance

    **Your Future - Crisis-Proof and with Long-Term Perspective**: · The Circet Group is one of the global leaders in the construction and operation of fixed-line and mobile networks. · As part of our continuous growth, we are currently looking for a **Technical Clerk - Construction ...

  • Eclipse Enterprises

    Automotive Test Engineer

    1 week ago

    Eclipse Enterprises Clay, United States

    WHAT WE ARE LOOKING FOR · Definition and creation of necessary test data, derivation of test cases from requirements and execution of test cases · Coordination of interface requirements with internal developers or development partners · Conducting vehicle tests with a focus on sy ...

  • Johnson Controls International

    HVAC TB Customer Support Coordinator

    5 days ago

    Johnson Controls International Fargo, United States

    What you will do · Under direct supervision of the Branch Service Manager, the Customer Support Coordinator: · Debriefs activities of assigned technicians/mechanics daily, coordinating with technicians/mechanics to resolve concerns quickly; · Partners effectively with the Servi ...

  • MasTec Inc.

    Project Executive

    1 week ago

    MasTec Inc. Fargo, United States

    Overview · Responsible for directing, planning and managing multiple construction project(s) ensuring projects are financially successful, safe and quality driven, as well as fostering and growing new client relations. The Project Executive will be assigned to one or more Clients ...

  • MasTec Inc.

    Wind Senior Estimator

    1 week ago

    MasTec Inc. Fargo, United States

    Overview · This position will generally lead large conceptual EPC bids where experience plays a vital role in developing a good estimate. Senior Estimators report to the Director of Estimating. This position will be assigned to large projects with responsibility for all aspects o ...

  • MAXIMUS

    Nurse - Consultant

    6 days ago

    MAXIMUS Fargo, United States

    Description & Requirements · Maximus is looking to fill a Nurse Consultant position. This role includes reviewing medical records, resolving technical issues, assessing facts, and undertaking special projects such as legal and medical research, proposal drafting, and project li ...

  • Cummins

    Diesel Technician

    1 week ago

    Cummins Fargo, United States

    Diesel Technician · Description · We are looking for a talented Diesel Technician to join our team Fargo, ND. · In this role, you will make an impact in the following ways: · * Complete repairs on engine products in a service shop · * Perform maintenance/repairs utilizing diagnos ...

  • KeyStaff Professionals- A Division of Midwest Staffing

    Civil Project Engineer

    2 days ago

    KeyStaff Professionals- A Division of Midwest Staffing Fargo, United States

    Our client is growing and seeking a Civil Project Engineer and play a pivotal role in overseeing all aspects of construction projects. You'll support the Project Manager and Management Team in financial administration and cost reporting, ensuring project success from start to fin ...

  • Wallwork Truck Center

    Wallwork Tuck Center Truck Body Technician

    1 week ago

    Wallwork Truck Center Fargo, United States

    Wallwork Truck Center is currently hiring for Truck Body Technician to join our team. (Pay $18-$34/hr. DOE.) If you are interested in working for a successful company and great working environment, this is the place for you Typical scheduled hours are Monday-Friday; 8 a.m.-5 p.m. ...

  • CITY OF MOORHEAD

    Payroll Coordinator

    1 week ago

    CITY OF MOORHEAD Fargo, United States

    The City of Moorhead is accepting applications for a Payroll Coordinator in the Finance Division of the Administration Department. This skilled technical position performs intermediate work processing payroll, ensuring compliance with applicable laws, policies and contracts, veri ...

  • South East Education Cooperative Consortium

    CCA Health and Safety Specialist

    1 week ago

    South East Education Cooperative Consortium Fargo, United States

    Position Type: · SEEC - Child Care Aware/Child Care Aware · Date Posted: · 8/23/2023 · Location: · South East Education Cooperative · Date Available: · Immediate · Closing Date: · Until Filled · District: · South East Education Cooperative - websiteJob Title: CCA Health & Safety ...

  • Marsh McLennan Agency

    Client Executive

    1 week ago

    Marsh McLennan Agency Fargo, United States OTHER

    Client Executive– Employee Health & Benefits – Grand Forks or Fargo, ND (MMA Upper Midwest) · Our not-so-secret sauce. · Award-winning, inclusive, Top Workplace culture doesn't happen overnight. It's a result of hard work by extraordinary people. More than 9,000 of the industry's ...

  • Essentia Health

    medical laboratory technologist or mls

    1 week ago

    Essentia Health Fargo, ND, United States

    Job Description: · Will perform and report tests of all complexity levels, as defined by CLIA, on patients of all ages to assist with the routine screening, diagnosis, treatment and management of diseases and injuries; will interpret and correlate test results with disease states ...

  • ICONMA

    Electronic Design Engineer

    1 week ago

    ICONMA Fargo, United States

    Electronic Design Engineer · Location: Fargo, ND · Duration: 6 Months with possible extension · Description: · Major Purpose: · Plans, coordinates, performs product design, testing and/or analysis work for a complete project of moderate scope or for a significant portion or ...

  • First International Bank and Trust

    Commercial Lines

    1 week ago

    First International Bank and Trust Fargo, United States

    Commercial Lines - Customer Service Representative · Department: Insurance Support · Location: Fargo, ND · PT/FT/Temporary : Full Time · START YOUR APPLICATION ) · We are seeking someone for a Commercial Insurance CSR position in our Insurance Department. In this role you will co ...

  • First International Bank and Trust

    Commercial Account Manager

    1 week ago

    First International Bank and Trust Fargo, United States

    Commercial Account Manager · Department: Insurance Support · Location: Fargo, ND · PT/FT/Temporary : Full Time · START YOUR APPLICATION ) · We are seeking someone for a Commercial Insurance CSR position in our Insurance Department. In this role you will communicate daily with ins ...

  • Tecta America Corporation

    Safety Coordinator

    1 week ago

    Tecta America Corporation Fargo, United States

    · Safety Coordinator · Position Identification: · Non-Exempt · Reports to: Director of HR and Safety · Position Summary: · The Safety Coordinator ensures compliance with all applicable Federal, State and local safety regulations governing the construction industry at the facilit ...