Provider Auditor I

Accountabilities

• • Initiate, plan, conduct, and finalize audits of financial, management, and administrative procedures associated with assigned provider cost reports.

  • Determine the appropriate scope, procedures, and testing requirements for individual reviews based on applicable audit programs and established standards.

  • Analyze audit programs and ensure required procedures are performed accurately and consistently within the defined scope.

  • Conduct financial analysis, limited and full desk reviews, and in-house or on-site field audits as assigned.

  • Exercise independent judgment when evaluating audit findings, making review decisions, and identifying opportunities to reduce organizational and quality-control risks.

  • Participate in and facilitate provider meetings, entrance conferences, walkthroughs, and exit conferences throughout the audit lifecycle.

  • Develop and maintain appropriate audit documentation and workpapers supporting testing, findings, adjustments, and conclusions.

  • Analyze provider financial statements and assess potential risks and their impact on Medicare funds.

  • Prepare, communicate, and issue corrective action plans and audit adjustment reports to consultants, CPA firms, management teams, and provider executives.

  • Communicate audit findings clearly and professionally, both verbally and in writing, with internal and external stakeholders.

  • Collaborate with internal and external customers to obtain, organize, and distribute requested information and documentation.

  • Participate in special projects and process-improvement initiatives, documenting work and contributing ideas that enhance audit effectiveness and operational efficiency.

  • Maintain required continuing education, including a minimum of 80 Continuing Education Training (CET) hours every two years.

  • Follow applicable CMS requirements, privacy and security standards, compliance policies, and other relevant laws and regulations.

  • Perform other related duties as assigned.

  Requirements

  • Bachelor’s degree in Accounting, Business, Finance, or a related field, or equivalent professional experience.

  • Working knowledge of accounting theory, principles, and practices.

  • Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint.

  • Strong analytical and problem-solving abilities, with the capacity to evaluate financial information and identify potential risks.

  • Excellent written and verbal communication skills, particularly when explaining audit findings and corrective actions to varied audiences.

  • Strong organizational and time-management skills, with the ability to manage audit documentation, deadlines, and multiple assignments.

  • Ability to exercise independent judgment and make sound decisions while following established policies and audit standards.

  • Professional and confident interpersonal skills, with the ability to interact effectively with healthcare providers, facility management, consultants, CPA firms, and other stakeholders.

  • Strong attention to detail and commitment to accuracy, quality, confidentiality, and regulatory compliance.

  • Ability to participate effectively in meetings, walkthroughs, entrance conferences, and exit conferences.

  • Ability to work with confidential financial and healthcare information while following applicable privacy and security requirements.

  • The physical work location must be within one of the 50 U.S. states or the District of Columbia.

  • The position requires prolonged sitting and telephone use, regular computer and office-equipment use, and occasional lifting of up to 15 pounds and stooping.

  • Certain positions may require federal identity verification, background investigation, credentialing, and access authorization. Where applicable, eligibility for federal credentials may require having resided in the United States for at least 3 of the previous 5 years.

  Benefits

  • Hourly pay range of $21.91–$36.04, with actual base pay determined by factors such as geographic location, internal equity, job-related knowledge, skills, and experience.

  • Incentive plan and lifestyle benefits.

  • Health, dental, and vision insurance.

  • Voluntary insurance plans.

  • Health Savings Accounts and Flexible Spending Accounts.

  • 401(k) retirement plan with company matching.

  • Company-paid life insurance.

  • Education assistance program.

  • Paid sick leave and paid holidays.

  • Increasing PTO accrual plan.

  • Medical, parental, and disability leave.

  • Workers’ compensation coverage.

  • Retiree benefits.

  • Severance package.

  • Employee assistance program.

  • Financial and health wellness benefits.

  • Casual dress environment.

  • Online learning and development resources.

  • Full-time remote/work-from-home opportunity.

  • No required travel.