PDReport .us



State of MichiganCivil Service CommissionPosition Code1. AUDITORAF54NCapitol Commons Center, P.O. Box 30002Lansing, MI 48909POSITION DESCRIPTIONThis position description serves as the official classification document of record for this position. Please complete the information as accurately as you can as the position description is used to determine the proper classification of the position.2. Employee's Name (Last, First, M.I.)8. Department/AgencyMDHHS-COM HEALTH CENTRAL OFF3. Employee Identification Number9. Bureau (Institution, Board, or Commission)Audit, Review, and Quality Assurance4. Civil Service Position Code Description10. DivisionAuditor-AHospital & Clinic Reimbursement5. Working Title (What the agency calls the position)11. SectionSenior AuditorHospital Settlement Section6. Name and Position Code Description of Direct Supervisor12. UnitCASTAGNASSO, CRAIG; STATE ADMINISTRATIVE MANAGER-17. Name and Position Code Description of Second Level Supervisor13. Work Location (City and Address)/Hours of WorkGENSTERBLUM, SHERRI L; STATE DIVISION ADMINISTRATOR400 S PINE ST; LANSING, MI 48933 / 8-5 M-F14. General Summary of Function/Purpose of PositionThis position is responsible for reviewing the desk audits of all hospitals’ electronic filed cost information and completed hospital settlements.? The cost information is filed by way of Michigan Medicaid Forms (MMF) and the Medicare cost reporting forms (CMS 2552-10).? The information contained in those forms provides the basis for reimbursement principals affecting over $2 billion annually.? This position is considered the primary subject matter expert regarding the regulations, State and Federal, covering the completion of the cost information data.15. Please describe the assigned duties, percent of time spent performing each duty, and what is done to complete each duty.List the duties from most important to least important. The total percentage of all duties performed must equal 100 percent.Duty 1General Summary:Percentage:75Review the work of the journey auditor to ensure that the filed cost report data (CMS 2552-10 and MMF) is as accurate and complete as possible. The Senior auditor works with eh journey auditor and technical support personnel to resolve any discrepancies that exist in the filed cost reports. This review is necessary because the data is used in such critical areas as hospital rate setting, special finance pool distribution, policy remodeling, budget hearings, and various other projects. Once satisfied that the filed data is accurate and complete, approval is given to load it into the database.Individual tasks related to the duty:Review cost acceptance/final settlements prepared by staff auditors consisting of:Review Comparison Output Summary (COS) for 162 hospitals.Delinquent letters to providers who do not file their MMF & CMS 2552 plete Acceptability Checklist including preparing comparison worksheets and tracing data from MMF to CMS 2552.Correction/variance letter to provider and monitor for 15 day required response.Review data submitted by providers, follow up as needed.Review cost acceptance package going to provider.Validate program data (prices, days, charges, and payments) from the paid claims file to insure data accuracy for use in provider settlements.Review calculated hospital final settlements including the accuracy of all working papers and audit adjustments.Verify calculated payment/take back amounts derived from the settlement calculationDuty 2General Summary:Percentage:10Make recommendations for improvements on controls, methodologies, and other changes to improve the efficiency of the cost acceptance process, comparison output summary (COS), and the hospital cost settlement system (HCS). Act as subject matter expert and provide guidance to staff auditors.Individual tasks related to the duty:Continually evaluate internal processes and offer suggestions on how they can be improved.Review audit staff working papers and provide review notes and corrective action.Analyze the hospitals financial statements to determine the long-term viability of the entity. Duty 3General Summary:Percentage:10Confers with officials of federal, state, and local agencies, legislators, governor’s aides, professional organizations, and interest groups on matters relating to cost reports and any data derived therefrom.Individual tasks related to the duty:Works with other department officials (DTMB, Consumer and Industry Services, State Building Authority, Attorney General, House and Senate Fiscal Agencies) as well as outside professional and provider organization officials on matters relating to hospital cost reports.?Coordinates with the Medicare Intermediaries on common audit and reimbursement issues.Works with outside contractors that have contracts with the Medicaid program and Hospital & Clinic Reimbursement Division relating to hospital filed cost reports and hospital settlements.Duty 4General Summary:Percentage:5Other duties as assigned.Individual tasks related to the duty:16. Describe the types of decisions made independently in this position and tell who or what is affected by those decisions. Decisions that affect the development, implementation, and maintenance of the Electronic Cost Report (ECR) software, the FCID’s databases, the COS, or the HCS systems.? Hospital expenditures of hundreds of millions of dollars are affected by decisions made governing these systems.17. Describe the types of decisions that require the supervisor's review. When the decision is highly political in nature and/or federal funding is questionable.18. What kind of physical effort is used to perform this job? What environmental conditions in this position physically exposed to on the job? Indicate the amount of time and intensity of each activity and condition. Refer to instructions.Office environment.19. List the names and position code descriptions of each classified employee whom this position immediately supervises or oversees on a full-time, on-going basis.Additional Subordinates20. This position's responsibilities for the above-listed employees includes the following (check as many as apply):NComplete and sign service ratings.NAssign work.NProvide formal written counseling.NApprove work.NNApprove leave requests.Review work.NApprove time and attendance.NProvide guidance on work methods.NOrally reprimand.NTrain employees in the work.22. Do you agree with the responses for items 1 through 20? If not, which items do you disagree with and why?Prepared by management.23. What are the essential functions of this position?Ensuring all Federal and State regulations are complied with in the completion of all hospital filed cost reports.? These reports are used as the data source in calculations affecting nearly $2 billion in annual reimbursement.24. Indicate specifically how the position's duties and responsibilities have changed since the position was last reviewed.Based on Senior Standards, the employee is?performing as senior on duty?#10.25. What is the function of the work area and how does this position fit into that function?The Hospital & Clinic Reimbursement Division provides for the Title XIX and Title V rate reimbursement and cost settlement for hospitals, rural health clinics, federally qualified health centers, tribal health centers, qualified health plans, special health plans and state psychiatric hospitals.? The division is responsible for the formation of policy and operational control of a variety of reimbursement methodologies for the department.? This Section provides for the Title XIX and Title V reimbursement, settlement, and reporting for hospitals in compliance with the Social Security Act, the Michigan Social Welfare Act and their related regulations and plans.? This position has the responsibility for reviewing desk reviews of hospital cost reports and settlements prepared by the Section’s professional auditors and paraprofessional staff.26. What are the minimum education and experience qualifications needed to perform the essential functions of this position.EDUCATION:Possession of a bachelor's degree with at least 24 semester (36 term) credits in accounting.EXPERIENCE:Auditor 12Three years of professional experience auditing accounting, financial, and operations records equivalent to an Auditor, including one year equivalent to an Auditor P11.Alternate Education and ExperienceAuditor 9 - 12Possession of a bachelor's degree with 24 semester credits (36 term) in finance, information systems, or management may be substituted for the education for positions responsible for internal auditing.Possession of a Certified Internal Auditor certification or a Certified Information System Auditor certification may be substituted for one year of experience at the P11 level for positions responsible for internal auditing.Possession of a Certified Management Accountant certification (CMA) may be substituted for six months of experience at the P11 level.Possession of a Certified Public Accountant certification (CPA) may be substituted for one year of Auditor experience.KNOWLEDGE, SKILLS, AND ABILITIES:Thorough knowledge of auditing techniques, financial analysis and program policies and goals.? Ability to instruct, direct, motivate, and evaluate employees.? Effectively maintain positive public relations with the private industry and cooperative relationships with other departmental officials and professional personnel.CERTIFICATES, LICENSES, REGISTRATIONS:None.NOTE: Civil Service approval does not constitute agreement with or acceptance of the desired qualifications of this position.I certify that the information presented in this position description provides a complete and accurate depiction of the duties and responsibilities assigned to this position.SupervisorDateTO BE FILLED OUT BY APPOINTING AUTHORITYIndicate any exceptions or additions to the statements of employee or supervisors.n/aI certify that the entries on these pages are accurate and complete.JANICE STUART2/13/2018Appointing AuthorityDateI certify that the information presented in this position description provides a complete and accurate depiction of the duties and responsibilities assigned to this position.EmployeeDate ................
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