Position Description: HMS, LTC Auditor

This position is no longer open, but you are welcome to submit your information so that we have it on hand for future similar positions. Also, if you haven't already, please be sure to set up a notifier so you will be alerted when there are new positions that meet your criteria.

Opportunity Snapshot

Open new doors of opportunity for your career as you recover billions of dollars of overpayments at the undisputed industry leader in coordination of benefits & program integrity services for government healthcare programs.

Joining our newly created Audit team, you will manage a variety of desk-based audits with nursing homes and other long term care providers, identifying inefficiencies and reporting the results to management. Pivotal to your success are top-notch communication and interpersonal skills to build strong working relationships with providers (you'll be working with providers remotely primarily via email and phone) and get the desired information in a timely manner. Of course, detail orientation and accuracy are at the heart of this role. You'll also showcase self-initiative to concurrently manage multiple audits and aim to meet and exceed your recovery targets as you drive to results, effectively prioritizing and completing work within stringent deadlines.

Since 1985 HMS has focused exclusively on the healthcare industry and during that time we have partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars, and save billions more through cost avoidance. Our portfolio of services, one of the broadest in the industry, includes coordination of benefits for Medicaid-Medicare, third-party liability, and pharmacy services; overpayment recovery; provider audits; medical support enforcement; and more. While other companies are cutting back, HMS has posted 18% growth year over year since 2001 -- yet we still maintain an entrepreneurial small-company culture in which individuals can make a difference and shape their own career trajectories.

What Else You'll Bring to the Table

Bachelor's degree or equivalent combination of education & experience (we welcome recent grads).
0-2 years of nursing, LTC or similar healthcare background; however we are willing to train the right individual.
Analytical ability & business acumen to collect multiple sources of data and draw logical conclusions.
Impeccable communication skills, including active listening and in presenting findings and recommendations.
Solid computer proficiency with Microsoft office suite, including Word, Excel and PowerPoint to prepare reports, memos, summaries and presentations.
Ability to travel (up to 25%) to nationwide destinations.

What's in It for You

Right time, right place to make an impact -- with billions of dollars at stake, there is a strong emphasis among policy leaders (and the voting public) on cost containment and payment accuracy. Not only will you be able to "make your mark" as this program evolves, but you'll also become part of our Program Integrity division, a product line driven by an aggressive growth strategy.
Career advancement -- we're hiring now with an eye on the future, looking for impact players who can grow with us. You will be well positioned to transition into Senior Auditor and possibly Audit Management roles, depending on your ambition and aptitude.
Autonomy & empowerment -- we'll entrust you with the freedom and flexibility to achieve your objectives independently with significant latitude for initiative and independent judgment.
A culture of growth and transition -- while we are growing strongly, we maintain the culture of a smaller company: employee input is welcome, and even new employees can make a visible impact in short order. Because of our growth we are looking for people with the initiative and resourcefulness to "take the ball and run with it." Excellence and innovation are highly valued.
Excellent benefits -- in addition to a competitive salary and bonus potential, we offer a comprehensive benefits package that includes a 401(k) plan with generous employer match, flexible spending plans, and much more.

More About Your Role

This is an individual contributor role and you'll report directly to the Manager of LTC Provider Audits as you join a team of six auditors at our Windsor office.

As you come on board, you'll receive comprehensive hands-on training on our audit processes/software. After a six-month training period, we'll expect you to independently manage your audits, meet your revenue goals and begin making a real impact.

Generally our auditing process is a six-month affair and you'll juggle as many as 20-25 audits concurrently in various stages of completion; you may be actively working on 6 or more audits while you schedule and do advance planning for the upcoming audits and finalize others as you report your findings.

Keys to Success

To excel in this role you will bring a strong understanding of the way healthcare claims work; this includes the nuances of provider billing, coordination of benefits, and privacy issues. You will balance a consultative, problem-solving style with an aggressive, entrepreneurial drive. You'll independently drive your audits, maintaining a big-picture focus while keeping a razor-sharp handle on day-to-day details and employing sound judgment to develop accurate assessments and recommendations.

And finally, you'll continually evaluate our systems and processes to identify improvements and drive best practices to sustain our growth objectives.

If this sounds like the right mix of challenge and opportunity for you, and you meet the minimum qualifications, we want to hear from you!

Who We Are

Health Management Systems has always been focused exclusively on the healthcare industry. In 1985, we began providing third party liability identification and recovery services to our first Medicaid agency client. Since then, we've partnered with more than 45 Medicaid agencies, other state health programs, and more than 50 government-sponsored healthcare plans to help them recover billions of dollars and save billions more through cost avoidance.

We take a proactive approach to growing our company, both organically and via mergers and acquisitions, to ensure we provide our clients with a broad offering of best-of-breed cost containment strategies to meet their financial and operational goals.

We are an equal opportunity employer. EOE M/F/D/V