Account Resolution Specialist I - 300025

Fargo, ND
Join our team!
Feb 11, 2019
Job Type
Full Time
Job Summary

The Account Resolution Specialist supports business initiatives through systems analysis and evaluation of Noridian Healthcare Solutions' (NHS) business requirements as defined by the Centers for Medicare & Medicaid Services' (CMS) regulations and other key clientele. This position navigates organization systems to generate commissioned reports ensuring the organization is completing tasks in a timely and to acceptable standards using task lists, data gathering, and open communication with external clients.

Key Performance Indicators

• Strong communication and collaboration skills

• Ability to research and analyze data from multiple sources

• Prioritization and multi-tasking skills with high attention to detail

Essential Functions

Key Duties/Responsibilities/Accountabilities

• Monitors system generated reports used to support key accounts and completes task lists to ensure departmental timeliness and performance standards are met.

• Documents and prepares reports for accuracy, timeliness, or system issues in order to identify patterns.

• Prepares documentation for new system releases, updates, and testing.

• Provides analysis of any requested data reports prior to various deadlines.

• Determines proper resources to gather information and details regarding department inquiries.

• Utilizes internal and external resources, system support, and databases to gather and address specific settlement details, inquiries, and system issues.

• Clearly documents sources and validates the accuracy of data/information to resolve inconsistencies.

• Reviews financial reconciliation reports submitted to CMS and other department appointed accounts on a monthly, quarterly, and annual basis.

• Collaborates with external entities to progressively resolve escalated collections.

• Reviews untimely debt and initiates the debt collection services from the United States Department of Treasury.

• Provides status of financial condition of the Medicare trust fund by collecting, interpreting, and reporting key financial data.

• Determines approval or denial of suppliers' requests for extended repayment (ERS) after reviewing the supplier's financial documents, Medicare history, and ERS history.

• Fosters relationships with primary accounts and maintains a collaborative understanding.

• Monitors all overpayments identified in the system and creates Intent to Refer letters to be sent to the US treasury.

• Analyzes CMS change requests and assists with the development of any changes or new processes that must be implemented to meet CMS requirements.

Non-Essential Duties and Functions

• Other duties as assigned.



Minimum Qualifications:

• Associate's degree in accounting, business, or related field required or equivalent work experience

Preferred Qualifications:

• Bachelor's degree in Business or Accounting

• Medicare operations experience

• Strong communication 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 usage
  • 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 by management.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency-specific regulations and related clauses included in NHS's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

Other Information

Job Posting Policy 6.05

New employees with Noridian Healthcare Solutions will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply.

Equal Employment Opportunity

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email

This job posting will be closed 2/18/2019 at 8:00AM CST. No further applications will be considered.

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