Overview
QA IT Analyst Jobs in Durham, NC at Aurobindo Pharma USA, Inc.
*Position is eligible for Remote / Work from Home opportunity*
Department: Provider Audit
Telecommuting Eligible: Yes
Job Grade: E11
As a condition of employment physical work location must be in one of the 50 states or the District of Columbia.
Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian (noridiansolutions.com)
Job Title
Provider Auditor II
Job Summary
The Provider Auditor is responsible for conducting Centers for Medicare & Medicaid Services (CMS) and other financial analysis, limited and full desk reviews, and in-house and on-site field audits to ensure proper reimbursement for health care providers for the Medicare programs. These positions are the face of Noridian interacting with providers/facilities management through the audit process which requires an advanced level of professionalism. Reviews assigned portions of audit programs, determines compliance with policies and procedures, recommends corrective action plans, and prepares/submits reports on the results of audits.
Essential Functions
Key Duties/Responsibilities/Accountabilities
Requires an intermediate level of working knowledge of Medicare rules, regulations (e.g., Code of Federal Regulations, Provider Reimbursement manual) to ensure reimbursement principles are properly applied to the Medicare Cost Report so that Medicare reimbursement is accurate
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and positive feedback
Identifies areas of opportunity, provides solutions and works towards implementation and/or training, documenting the updates and procedures for efficiency and process improvement
Provides support and input for specialized and in-depth projects with increased complexity
Resolves cost report reopening requests as assigned, reviewing documentation submitted to determine accuracy of the request and proposing applicable adjustments to the cost report
Works with externally facing provider representatives when necessary to resolve appeal cases, including writing position papers and auditing documents
Possesses ability to Lead basic audits
Requires advanced knowledge of documentation requirements from audit testing through preparation of audit workpapers
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, Finance or equivalent work experience
1-year Medicare auditing experience
Knowledge of accounting theory and practices
Proficient in Microsoft Office Suite (Word, Excel, Outlook, and PowerPoint)
Demonstrated knowledge of Medicare/Medicaid regulations, health care terminology, and various software packages and applications such as Medicare Cost Report software (HFS Software)
Preferred Qualifications
Above requirements and the following:
Bachelor’s degree in Accounting, Business or Finance
Excellent written and verbal communication skills
Excellent organizational skills
Environment and Cognitive/Physical Demands
Office Environment
Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
Requires prolonged sitting and telephone use
Requires the use of office equipment such as computer terminals, telephones, copiers and printers
Infrequent lifting to 15 pounds
Infrequent stooping
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.
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.
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, 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.
An employee in this position may be required to possess a “Federal Identification Card” (Federal ID) as a condition of employment. Federal ID’s may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.
Equal Employment Opportunity
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Below is the salary range for potential new hires.
Salary Range: The pay range for this position is $52,120.20 – $85,724.33 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
Other Compensation: Incentive Plan & Lifestyle Benefit
This job will be posted until filled.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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Title: QA IT Analyst
Company: Aurobindo Pharma USA, Inc.
Location: Durham, NC
