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Supv Provider Audit

Role overview

Qualifications

  • Bachelor's degree in Accounting, Business, Finance, OR equivalent work experience
  • 5 years' Medicare auditing experience
  • Advanced knowledge of Medicare reimbursement principles and regulations
  • Strong verbal and written communication skills

Responsibilities

  • Meets contractual obligations and performance standards while ensuring quality performance of staff
  • Prioritizes and delegates workload for direct reports
  • Coaches and develops staff by encouraging growth to ensure expectations are met
  • Participates as the area Subject Matter Expert (SME) for internal and external customers

Key facts

Hard skills

Other skills

  • Leadership
  • Analytical Skills
  • Social Skills
  • Microsoft Office
  • Communication
  • Problem Solving
  • Teamwork

About the company

Noridian Healthcare Solutions, LLC logo

Noridian Healthcare Solutions, LLC

Digital Health & Health Tech

Noridian Healthcare Solutions, LLC (Noridian) develops solutions for federal, state and commercial health care programs through a full suite of innovative offerings, including claims processing, medical review, and contact center and provider administrative services. Headquartered in Fargo, N.D. with staff located throughout the nation, Noridian administrates people-first services across all 50 U.S. states. Leveraging its decades of experience, the Noridian team designs and implements customizable, high-quality solutions to eliminate common health care barriers, enabling access to care.

Company details

Company typeLarge
IndustryDigital Health & Health Tech
Company size1001 - 5000

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Job description

* Position is Eligible for Remote / Work from Home Opportunity*

Department: Provider Audit

Telecommuting Eligible: Yes

Job Grade: E13

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

Supervisor Provider Audit

Job Summary

The Supervisor Provider Audit is responsible for leading and development the Centers for Medicare & Medicaid Services (CMS) provider audit and reimbursement employees to ensure the team is administering the organization's contract with the best possible service while maintaining contract expectations and performance metrics within the budget and time constraints.

Essential Functions

Key Duties/Responsibilities/Accountabilities

  • Meets contractual obligations and performance standards, while ensuring quality performance through the performance management of staff and implementing internal controls
  • Prioritizes and delegates workload for direct reports, ensuring workflow is monitored and adjusted as needed to ensure workloads are completed in a timely manner based on internal and external standards
  • Coaches and develops staff by encouraging growth to ensure staff are meeting expectations
  • Initiates disciplinary action when performance does not meet expectations and documents and follows up with disciplinary plans, conversations, and decisions appropriately
  • Provides ideas and initiates innovation in areas of process improvements and technology enhancements
  • Leads by example by promoting teamwork, recognition, and leadership while demonstrating company values
  • Responds to and implements change in a flexible, positive manner
  • Participates as the area Subject Matter Expert (SME) and resources for internal and external customers, which may include CMS, government officials, provider representatives, and other various contractors
  • Serves as a resource point for internal and external customers including CMS and various contractors
  • Participates in budget process for area
  • Provides analytical and broad-based view of systems by acquiring and maintaining a thorough knowledge of all systems and subsystems used to administer the Medicare program and other lines of business
  • May conduct reviews of all departmental activities, including in-depth analysis of complex reimbursement structures identified in the Medicare cost report which are in accordance with CMS and the Code of Federal Regulations

Non-Essential Duties and Functions

  • Other duties as assigned

Minimum Qualifications

  • Bachelor's degree in Accounting, Business, Finance, OR equivalent work experience
  • 5 years' Medicare auditing experience
  • Advanced knowledge of Medicare reimbursement principles and regulations and Medicare Cost Report
  • Advanced knowledge of accounting theory and practices
  • Proficient in Medicare/Medicaid regulations, healthcare terminology, and various software packages and applications
  • Demonstrated an understanding of industry and enterprise objectives
  • Strong verbal and written communication skills
  • Ability to build effective interpersonal relationships within the workplace
  • Ability to motivate and manage a large group of people
  • Ability to direct and maintain a productive and dynamic working environment
  • Ability to coordinate activities among team
  • Ability to problem solve and develop problem solving skills within staff

Preferred Qualifications

Above requirements and the following:

  • 3 years' experience in leadership
  • Expertise in working with the STAR database
  • Ability to create and conduct presentations
  • Strong PC skills, including advanced knowledge in Microsoft Office applications (Work, Excel, Outlook, PowerPoint etc.)
  • Excellent organization skills
  • Strong analytical skills and attention to detail
  • Experience in technical or medical applications
  • Experience in large scale project management

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
  • Travel up to 25%

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, Severance Package, 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. 

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c) 

Below is the salary range for potential new hires.

Salary Range: The pay range for this position is $68,928.86 – $104,299.96 per year. 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 closed 09/16/2026 at 8:00AM CST.  No further applications will be considered. 

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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