GSPARD Audit Assoc 2 - First Coast Service Options
GuideWell Source is a leading administrative services company, and a subsidiary of GuideWell Mutual Holding Corporation, that provides full-service, end-to-end business services for health plans and government-sponsored health care programs like Medicare.
* Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
* Short- and long-term disability benefits
* 401(k) plan with company match and immediate vesting
* Free telehealth benefits
* Free gym memberships
* Employee Incentive Plan
* Employee Assistance Program
* Rewards and Recognition Programs
* Paid Time Off and Paid Sick Leave SUMMARY STATEMENT
The PARD Audit Associate 2 is responsible for supporting the Provider Audit and Reimbursement team by completing tentative settlements and desk reviews on Skilled Nursing Facilities (SNF), End Stage Renal Disease (ESRD) and Federally Qualified Health Centers/Rural Health Clinics (FQHC/RHC) providers.
ESSENTIAL RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
Reviews cost report and Provider Statistical and Reimbursement report (PS&R) information to determine accurate and timely SNF, ESRD and FQHC)/ (RHC) tentative settlements of bad debt payments or other pass-through costs. Reviews the cost report and accompanying bad debt logs to update pass-through payment amounts and determines lump-sum adjustments for interim rate accuracy. (40%)
Performs limited desk reviews of cost reports for SNF, ESRD, FQHC/RHC, and Balance Budget Act (BBA), BBA ESRD reviews for providers that receive Medicare reimbursement. Generates all required internal and external correspondence and checklists to facilitate implementation of and evidence of completion of the desk reviews. (35%)
Serves as a specialist over one or more various projects that could include duplicate interns and residents (IRIS) data, system for tracking audit and reimbursement (STAR) updates, including the tracking of providers, cost reports and continuing education and training (CET), Health Financial Systems (HFS) cost report software, SNF pass through logs, and PS&R backup. (15%)
Assists management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report files, completing reconciliation reports, participating in continuous improvement projects, etc. (10%)
Performs other duties as the supervisor may, from time to time, deem necessary. REQUIRED QUALIFICATIONS
* High School Diploma or GED
* 4 years' related experience in one or more of the following: Medicare cost reporting, finance, accounting, healthcare accounting, auditing or reimbursement PREFERRED QUALIFICATIONS
* Associate degree in Accounting or related field
* Two years' experience in Medicare cost reporting
* Experience using HFS cost report softwareQualificationsThe Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive. "We are an Equal Opportunity/Protected Veteran/Disabled Employer." This opportunity is open to remote work in the following approved states: AL, FL, GA, ID, IN, IO, KS, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require additional approval. In FL and PA in-office and hybrid work may also be available.
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Job type
Full Time
Experience level
Entry-level
Location requirements
Hiring timezones
United States +/- 0 hoursAbout GuideWell Source
Learn more about GuideWell Source and their company culture.
The story of GuideWell Source is one of evolution and strategic alignment within the American healthcare landscape. Its journey began under the name Diversified Service Options, Inc., a company established in 1998 with a focus on providing crucial administrative services for government-sponsored healthcare programs. For years, it operated as a key player behind the scenes, ensuring the smooth functioning of Medicare and Medicaid by managing claims, serving beneficiaries, and supporting healthcare providers. This foundational period was marked by a commitment to operational excellence and fiscal responsibility, building deep expertise in the complexities of federal health programs and forging a strong relationship with the Centers for Medicare and Medicaid Services (CMS).
A pivotal moment in the company's narrative occurred in 2015 when Diversified Service Options underwent a significant rebranding to become GuideWell Source. This was more than just a name change; it was a strategic move to more closely align with its parent organization, GuideWell Mutual Holding Corporation, a major not-for-profit health solutions enterprise. The new identity as GuideWell Source was designed to convey its role as an expert resource and a forward-thinking partner in the broader health ecosystem. This transformation solidified its position within the GuideWell family of companies, which includes Florida Blue, the state's leading health insurer. Today, GuideWell Source continues its mission as a trusted administrator, leveraging its decades of experience and its place within an integrated health solutions powerhouse to innovate and enhance the delivery of government healthcare services to millions of Americans. Through its subsidiaries, like First Coast Service Options and Novitas Solutions, it proudly serves over 11 million beneficiaries and hundreds of thousands of healthcare providers across the United States.
Tech stack
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Employee benefits
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Paid Time Off
We also offer paid time off.
Life Insurance
We also offer life insurance.
Retirement Plans
We also offer retirement plans.
Health and Wellness Incentives
We also offer health and wellness incentives.
GSGuideWell Source
Company size
1001-5000 employees
Founded in
1998
Chief executive officer
Harvey Dikter
Markets
Employees live in
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