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Job Title: Field Auditor - NJ
Job Location: NJ: Cranford
Pay Rate: Open
Job Length: full time
Start Date: 2008-09-19

Company Name: BlueCross/BlueShield
Contact: HR
Phone: email only please
Fax: email only please

Description: Field Auditor - NJ Category: Audit Plan: TN-Blue Cross and Blue Shield of Tennessee Division: Government Claims City: Cranford State: NJ Type: Full Time

Description:To apply please visit our website at http://www.bcbst.com/about/careers/openings/ This position reports directly to the Audit Supervisor. A field auditor interacts with In-Charge and Senior Auditors as well as provider representatives and is accountable for contributing to the accurate and timely completion of Medicare cost report audits and settlements. This position is expected to comply with CMS instructions and corporate and department policies and procedures. In the New Jersey office, this position is also accountable for contributing to the accurate and timely completion of Medicaid audits and settlements as well as audits for The Department of Health and Senior Services (DHSS) contracted providers. Functions Analyzes and evaluates submitted cost reports to accurately complete tentative settlements and desk reviews to ensure proper provider payments. Participates in the completion of Medicare and Medicaid (as applicable) audits to ensure proper provider adherence to government agency policies. Calculates Medicare and Medicaid (as applicable) final settlements incorporating desk review and/or audit adjustments in accordance with Medicare and Medicaid reimbursement principles. Assists with provider cost report reopenings and/or appeals, as necessary. Ensures that Riverbend Government Benefits Administrator meets or exceeds the audit quality performance standards of CMS, CPE, and AQRP reviews by completing quality work. The focus of most review tasks relate to the allowability of cost charged to the Medicare program and the acceptability of principles and systems utilized by the provider. The Auditor will prepare workpapers in accordance with CMS requirements to support decisions made during the reviews. The Auditor is free to make review decisions when precedents and guidelines exist; however, when guidelines are not clear or do not exist, the Auditor can consult with the In-Charge or Senior Auditor and/or Audit Supervisor. Close supervision will be needed at this level.

Qualifications:A minimum of a BS Degree in the field of Accounting. It is highly desirable for the candidate to have at least a 3.0 GPA in Accounting when entering this position and be within one year of graduation. Proficient with Microsoft Excel, Word, and Outlook Excellent verbal and written communication skills Some overnight travel in NJ and use of personal automobile required Auditor must comply with CMS Publication 100-06, Chapter 8, section 80.1, Continuing Education requirements. Req Code: 0800859

Please refer to Job code bluecross-18643 when responding to this ad.

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