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Long Term Care Auditor I

Date:  Jan 5, 2022
Location: 

Any city, TX, US, 99999

Req ID:  7283

Summary

 

We are seeking a talented individual for a LTC Auditor I who is responsible for the identification and recovery of client improper payments made to long term care healthcare providers. 

Job Description

Essential Responsibilities:

  • Interpreting and applying federal and state Medicaid regulations, statutes, and policies pertaining to long term care.
  • Analyzing provider records from multiple accounting software programs.
  • Identifying improper payments relating to inaccurate payments, collections, and coordination of benefits.
  • Acting as the primary liaison with their assigned long term care providers.
  • Managing 40+ audits in varying phases
  • Responsible for provider reporting and communication.
  • Responsible for status reporting to management.

Non-Essential Responsibilities:

  • Performs other functions as assigned

Job Description

Knowledge, Skills and Abilities:

  • Strong analytical skills and an ability to overcome obstacles and resolve problems.
  • Ability to function independently and effectively under pressure and deadline oriented project demands as well as manage multiple initiatives.
  • Ability to multi-task, establish priorities, and meet revenue objectives.
  • Must have excellent organizational and time management skills in order to manage multiple audits and meet or exceed revenue targets.
  • Must have exceptional written and oral communication and interpersonal skills in order to build strong working relationships with both internal staff and assigned LTC providers.
  • Must be able to follow directives and adapt to shifting priorities as required.
  • Working knowledge of HIPAA privacy and Security rules. 
  • Professional, confident, and have a positive work attitude. 
  • Ability to perform well in team environment, with staff at all levels, to achieve business goals. 
  • Ability to maintain a professional demeanor and appearance at all time. 
  • Proficiency in PC based business applications including Microsoft Office (Word, Excel, Power Point, and Access).

Work Conditions and Physical Demands:

  • Primarily sedentary work in a general office environment
  • Ability to communicate and exchange information
  • Ability to comprehend and interpret documents and data
  • Requires occasional standing, walking, lifting, and moving objects (up to 10 lbs.)
  • Requires manual dexterity to use computer, telephone and peripherals
  • May be required to work extended hours for special business needs
  • May be required to travel at least 10% of time based on business needs

Qualifications

Minimum Education:

  • High School Diploma/GED required
  • Bachelor’s degree preferred

Minimum Related Work Experience:

  • Associates’ degree required
  • With Bachelor’s degree, no experience required 
  • In lieu of Bachelor’s degree, 1+ to 5 years’ experience required

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