WPS Health Solutions
Full Time

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Description Who We Are We are a leading not-for-profit health insurer in Wisconsin, and our services have grown to reach active-duty and retired military personnel, seniors, and families in Wisconsin, across the U.S., and around the world. Learn more WPS receives World's Most Ethical Company Award for 10th Year in a Row - 2019 Most Ethical Companies Announcement At Our Core WPS Health Solutions has earned a reputation as a leader in the insurance and benefits administration industry through our commitment to excellence and high-quality service. Our corporate values reflect the core of who we are and how we conduct business every day. Customer Focused I recognize how my actions impact internal and external customers by being responsible for the customer experience. I look beyond the immediate issue to recognize and solve the problem. Individual Responsibility I own my actions. I am accountable and dedicated to achieving the best results for WPS Health Solutions and our customers. I embrace my role in helping the company achieve a high-performance workplace. Mutual Respect I lead by example and act ethically, honestly and am trustworthy. I show appreciation for others by giving and taking constructive feedback and encouragement. Driven and Passionate I approach my work with enthusiasm, and personal commitment to the success of our business. I keep the importance of the work we do for our customers alive in my attitude and interactions with others, and demonstrate pride in the worthiness of our purpose. Position Summary The Auditor I will complete audits and desk reviews in accordance with government requirements to ensure accurate reporting of statistical and financial data reported on Medicare Cost Report. Position exists through a government contract with Centers for Medicare & Medicaid Services (CMS). Remote work may be available in the states of Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, Ohio, South Carolina, Texas, Virginia, and Wisconsin depending on experience. In this role you will: 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 in accordance with Government Auditing Standards and Centers for Medicare and Medicaid Services (CMS) requirements, during review, 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 interim work groups, providing input on work paper guidelines, techniques, and requirements. Stay abreast of current CMS regulations and WPS audit procedures. Defend reimbursement or audit decisions made during desk review and audit. Respond timely and accurately to provider inquiries. You should have: Bachelor's degree in Accounting, Finance, Math, Business, or related field OR equivalent post high school education and/or work-related experience Ability to complete CMS requirement of 80 hours of Continuing Education Training (CET) every 2 years Demonstrated understanding of accounting principles, auditing theories, or math conceptsobtained through formal education and/or work related experience We prefer: Experience auditing Medicare Cost Reports Stay connected: Sign-up for Job Alerts FOLLOW US Facebook Twitter LinkedIn Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities 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.