Audit & Reimbursement III and Senior

Audit & Reimbursement III

Location:

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Please note that, per our hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with CMS. Under guided supervision, you will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement, participate in contractual audit and reimbursement workload, and have opportunities on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry.

• Analyze and interpret data and make recommendations for change based on judgment and experience.
• Work independently on assignments and under minimal guidance.
• Prepare detailed work papers and present findings in accordance with GAS and CMS requirements.
• Gain experience with applicable federal laws, regulations, policies, and audit procedures.
• Respond timely and accurately to customer inquiries.
• Multi‑task while independently prioritizing work using time management, initiative, project management, and problem‑solving skills.
• Perform all duties of lower‑level positions as directed by management.
• Participate in special projects and review of work done by auditors as assigned.
• Assist in mentoring less experienced associates as assigned.
• Perform complex cost report desk reviews.
• Perform complex cost report audits as an in‑charge auditor, assisting other auditors.
• Depending on experience, perform supervisory review of work completed by other associates.
• Analyze and interpret data per provider’s trial balance, financial statements, financial documents, or other related healthcare records.
• Perform cost report acceptance, interim rate reviews, final settlements, and tentative settlements.
• Perform complex calculations related to payment exception requests and review exception request work papers prepared by others.
• Perform cost report reopenings.
• Participate in completing complex appeals work: position papers, jurisdictional reviews, and maintaining accurate records by updating logs, case files, and tracking systems.
• Participate in all team meetings, staff meetings, and training sessions.

• BA/BS degree and a minimum of 3 years of audit/reimbursement or related Medicare experience; or any combination of education and experience equivalent to the required background.
• Foreign national applicants must meet CMS TDL 190275 residency requirement (living in the U.S. at least three of the past five years).

• Degree in Accounting preferred.
• Knowledge of CMS program regulations and cost report format preferred.
• Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
• MBA, CPA, or CIA preferred.
• Must obtain Continuing Education Training requirements (where required).
• A valid driver’s license and ability to travel may be required.

Location:

This role enables associates to work virtually full-time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. Please note that, per our hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

The Audit and Reimbursement Senior will support our Medicare Administrative Contract (MAC) with CMS and manage contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement. This position provides advanced experience in auditing and financial analysis within a growing healthcare industry.