Audit & Reimbursement II
Core
Conducts limited and full desk reviews of healthcare providers, performing audits on End Stage Renal Disease (ESRD) providers and provider exception requests.
Role type
Mid-level audit specialist (healthcare reimbursement)
Builds
Audit findings and compliance recommendations for federal healthcare programs
Domain
Healthcare administration / Federal government reimbursement
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Desk review execution, data analysis, CMS program regulations knowledge, cost report format familiarity, Microsoft Excel/Word proficiency
Preferred skills
Accounting degree, MBA, CPA, CIA, CMS computer systems knowledge
Responsibilities
Perform assigned desk reviews on providers, assist on field work and appeals, update STAR/FISS/PSF systems, analyze data for recommendations, handle Part A provider enrollment
Seniority
Individual Contributor, non-management