Overview
GENERAL SUMMARY OF POSITION :
Under the direction of the Financial Compliance Unit (FCU) Director or designee, the Healthcare Auditor plays an integral role in program integrity and compliance by performing nursing home reviews and audits as well as managing vendor audits.
The FCU Healthcare Auditor has an essential role in maintaining the FCU Audit database and in assuring adherence to EOHHS and MassHealth regulations as well as FCU policies, procedures and processes.
The Healthcare Auditor will work both independently and within a team, interacting with a variety of healthcare providers, vendors and team members.
Responsibilities
MAJOR RESPONSIBILITIES :
- Coordinate and implement new products and projects
- Perform complex analysis in support of projects in and out of state
- Participate in developing proposal responses by providing documentation and analysis
- Assist in the preparation of client and staff presentations and marketing materials
- Provide support to staff performing consulting services
- Participate in project forecasting and financial analysis
- Present the research and development findings on industry trends to support revenue initiatives
- Assist in the development of agreements between public entities and the University
- Communicate with client as required concerning status of their projects
- Respond to client needs and requests
- Prepare internal and external reports
- Assist in the design of and implement instruments to quantify reimbursement costs
- Participate in the Continuous Quality Improvement program
- Assist in the preparation of federal claims for reimbursement
- Perform other job related duties as assigned
Qualifications
REQUIRED QUALIFICATIONS :
- Bachelor’s degree or equivalent
- 3-5 years of experience in a business related field or other related experience
- Preferred knowledge of State and Federal regulations as they apply to public assistance programs
- Demonstrated experience in computer based tools including spreadsheets and word processing
- Knowledge of accounting principles, budgeting, and computer reporting preparation
- Demonstrated project management skills
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