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Field Cost Report Auditor

Wisconsin Physicians Service Insurance Corporation

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Field Cost Report Auditor Who We Are WPS Health Solutions is a leading not-for-profit health insurer in Wisconsin. Our services offer health insurance plans for individuals, families, seniors, and group plans for small to large businesses. We process claims and provide customer service support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. In 2021, WPS Health Solutions celebrated 75 years of making health insurance easier for those we serve. Proud to be military and veteran ready. Our Culture WPS' Performance-Based Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an inclusive, empowering employee experience, focusing on People, Work, and Conditions. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities. We are guided by our Purpose: Together, making health care easier for the people we serve. In 2021 and 2022, WPS Health Solutions was recognized for several awards including: Madison, Wisconsin's Top Workplaces Top Workplace national cultural excellence awards for Remote Work and Work-Life Flexibility Achievers 50 Most Engaged Workplaces with the further honor of Achievers "Elite 8" winner in the category of Culture Alignment Role Snapshot Our Field Cost Report Auditor completes audits and desk reviews in accordance with government requirements for Centers for Medicare & Medicaid Services (CMS) to ensure accurate reporting of statistical and financial data reported on Medicare Cost Report. This role has a direct impact on confirming the US Tax funded Medicare program is working efficiently and cost effective. Lead and participate in completing Uniform Desk Review/Audit Program within interim and monthly production goals. Prepare audit adjustment reports and detailed sets of work papers based on Government Auditing Standards and CMS requirements, analysis, and audit/desk review of provider's cost report. Analyze expense and revenue data for reasonableness and compliance, review provider pricing policies for consistency in charges, and examine statistical data for cost allocations. Participate in work groups, providing input on work paper guidelines, techniques, and requirements. Work with and learn current CMS regulations and WPS audit procedures. Defend reimbursement or audit decisions made during desk review and audit based on documented regulations. How do I know this opportunity is right for me? If you: Thrive in a fast-paced environment that is deadline driven. Are extremely detailed oriented and can identify inaccuracies easily. Feel comfortable defending your decisions with data and facts. Excel at math and problem solving. Want to work in an environment with strong work life balance with flexible work hours. Are interested in working remotely in the comfort of your home - no driving time, gas costs, or wear and tear on your vehicle. What will I gain from this role? Work experience with a management team that is committed to maintaining a high performing work culture. Learn basic auditing principles that can spark career growth. A thorough introduction to healthcare reimbursement. Working remotely in the comfort of your home - no driving time, gas costs, or wear and tear on your vehicle. Experience in an environment that serves our Nation's military, veterans, Guard and Reserves along with their families. In addition, we also serve Medicare beneficiaries and providers. Minimum Qualifications Bachelor's Degree in related field or equivalent post high school and/or related work experience Preferred Qualifications Demonstrated understanding of accounting principles, auditing theories, or math concepts obtained through formal education and/or work-related experience. Medicare Cost Report experience. Healthcare experience. Accounting or Finance background. This role is open to 100% remote work for this opportunity in the following approved states: Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin Benefits The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience Currently we are targeting a base salary of around $47,000 - $50,000. WE ARE open to negotiation and consideration of experience, specifically experience with Medicare Audit Remote work Performance bonus and/or merit increase opportunities 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately) Competitive paid time off Health, dental insurance, Teladoc starts DAY 1 Review additional benefits here Sign up for Job Alerts FOLLOW US! LinkedIn Facebook Twitter
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