PDReport



State of MichiganCivil Service CommissionPosition Code1. AUDITORED56NCapitol 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)Bureau of Audit4. Civil Service Position Code Description10. DivisionAuditor-ELTC Audit5. Working Title (What the agency calls the position)11. SectionAuditor6. Name and Position Code Description of Direct Supervisor12. UnitWERNER, SCOTT R; STATE DIVISION ADMINISTRATOR7. Name and Position Code Description of Second Level Supervisor13. Work Location (City and Address)/Hours of WorkMYERS, PAMELA A; SENIOR MANAGEMENT EXECUTIVE320 S. Walnut Street, Lansing, MI (Lewis Cass Building) / Monday-Friday, 8am-5pm14. General Summary of Function/Purpose of PositionThe function and purpose of this position is to perform auditing and fiscal administrative duties relative to institutional providers in order to carry out the objectives of the Division.? The Division is responsible for the fiscal administration of the Medicaid Long Term Care (LTC) provider reimbursement program. The primary purpose is to assure LTC providers are being properly reimbursed in accordance with the State’s Medicaid State Plan and Medicaid Program policies to protect State funds.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:35Provider Cost Report AcceptanceComplete nursing facility annual cost report acceptance reviews to determine acceptance or rejection of filed cost report in accordance with Program policies.Individual tasks related to the duty:Analyze filed cost report for proper completion and adherence to Program reporting policies.Determine acceptance or rejection of cost report municate with nursing facility representatives to obtain additional supporting documentation of necessary data to complete the cost report acceptance determination.Draft letters to nursing facility representatives as needed to communicate cost report rejection or other determinations relative to cost report reviews.Discuss cost reporting issues and discrepancies with division manager to obtain guidance on how to address and resolve cost reporting problems. Duty 2General Summary:Percentage:25Prepare Audit PlansUtilize risk analysis, variance reports, provider filed cost report, and supporting documents to identify potential risk areas to include in audit scope. Individual tasks related to the duty:Plan and organize audit plan assignments to be completed in a timely manner.Prepare cost report variance reports necessary to analyze the current period's reported cost data to prior year cost data.Run risk analysis report.Analyze variance report data and risk analysis data to determine potential areas of higher risk and problem cost areas for potential audit review.Analyze nursing facility reimbursement status to determine cost reported data impact on the Program’s reimbursement levels.Assess level of risk to determine type of audit necessary. Submit completed audit work plan documents to division manager for approval. Duty 3General Summary:Percentage:25Desk Audit Review of ?Provider’s Filed Cost ReportPerform desk audit review or limited scope audit of institutional provider's filed cost reports to determine final acceptability of reported costs.Individual tasks related to the duty:Plan and organize audit work to efficiently complete testing. Calculate the reimbursement impact of an audit review by use of risk analysis.Review assets, liabilities, revenues, payroll, and various expense accounts along with statistical data in provider filed cost reports. When warranted, request additional provider documentation to determine allowability of provider’s reported costs. Prepare audit adjustment worksheet and enter audit adjustments in the audited cost report. Submit audit to supervisor for review. Revise as necessary.Prepare notification of audit results to the provider; respond to provider inquiries about audit adjustments on the audited cost report.Conduct an exit conference either by telephone or meeting with the provider and/or their designated representatives (attorneys, CPAs, board members, ect.).Communicate the rationale of each adjustment to the provider and/or their representatives.?Prepare written responses to provider’s objections about audit adjustments. Duty 4General Summary:Percentage:15Prepare Annual Provider SettlementsCalculate and prepare initial and final fiscal period cost settlements for long term care providers using provider submitted cost reported data or audited cost data.Individual tasks related to the duty:Determine whether an initial settlement or final settlement needs to be calculated.Determine which institutional provider is being settled and obtain Invoice Processing Payment Data report for that provider.Determine if previous gross adjustments or settlements have been paid to the provider, which impacts the settlement calculation.Utilize the provider’s submitted cost report data and calculate an initial settlement reimbursement rate. Calculate an initial settlement amount due the provider or (State) utilizing the initial settlement reimbursement rate and payment data report.Utilize the provider's audited cost data and calculate a final settlement reimbursement rate. Calculate a final settlement amount due the provider of (State) utilizing the final settlement reimbursement rate and payment data report.?Submit settlement package to supervisor for review.? Revise as necessary.16. Describe the types of decisions made independently in this position and tell who or what is affected by those decisions. Employee is expected to perform work independently to the extent of routine work, which varies by classification level.? Identify the rule, regulation, guideline, law, or principle applicable to the audit review, rate setting, or cost settlement assignment.? Determine the adequacy and appropriateness of provider’s cost reporting. Prepare workpapers to document review of scoped accounts and support decision to disallow expenses, offset income, or change the method or statistics used in the cost allocation. Audit workpapers and decisions are made independently and potentially affect a provider’s reimbursement payments. Draft correspondence to the provider requesting additional cost data or answering provider inquiries.?Reimbursement action decisions impact and determine proper expenditure level of State and Federal dollars to providers doing business with the Medicaid Program. These decisions also affect timeliness of payment or fund recovery actions processed to providers.? Audit staff’s review and analysis of providers’ cost reporting determine the level of audit work assignments for the Regional Offices. 17. Describe the types of decisions that require the supervisor's review. Final approval of audit review, rate setting, and settlement reimbursement actions.? Requests to the Regional Offices for an audit of a provider’s cost report.? Provider’s request for a reimbursement program exception. Any questionable situation concerning a cost area that could potentially impact many providers.? Unusual findings discovered during an audit will require the supervisor’s review and guidance to ensure adequate and proper audit techniques. Additionally, any unusual situations where guidelines or instructions are not available would require supervisor’s guidance.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.The position generally sits at either a desk or at a computer table to perform the job functions.? When retrieving or returning settlement files to the file room, it is necessary to walk to the file room, and either bend, kneel, or crouch and reach for the settlement files, lift the files out of file cabinet and carry the files to office or file room.? The files average 5 to 8 pounds.? Majority of time spent on job requires interaction with a computer.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?Yes.?23. What are the essential functions of this position?The position is responsible for assuring the proper reimbursement of long term care providers.? This involves the analysis of nursing facility cost reporting data for acceptance under program policies. The position also requires risk analysis and audit testing of the long term care providers’ annual cost reporting for program compliance with principles, reporting, and guidelines.24. Indicate specifically how the position's duties and responsibilities have changed since the position was last reviewed.New establishment.?25. What is the function of the work area and how does this position fit into that function?The LTC Audit Division is responsible for ensuring long term care providers are in compliance with State and Federal Medicaid Program requirements. The division auditor reviews and analyzes cost report data to assess a provider’s level of audit risk. This position also assists the Regional Offices by performing cost report audits and reviews. These audits and reviews determine the necessity of financial adjustments to be paid to or recovered from the reporting providers. Audits and review can also result in recommendations to responsible program offices for corrective actions against a licensed LTC provider. 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 9No specific type or amount is required.Auditor 10One year of professional experience auditing accounting, financial, and operations records equivalent to an Auditor 9.Auditor P11Two years of professional experience auditing accounting, financial, and operations records equivalent to an Auditor, including one year equivalent to an Auditor 10.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:As listed on the Civil Service job specification. In addition:Ability to use a personal computer.? Knowledge of Microsoft software products (WORD, EXCEL, and ACCESS) is desired.? Must have the ability to prioritize assignments and duties, make decisions, and communicate effectively both orally and in writing.The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect, and fairness.CERTIFICATES, LICENSES, REGISTRATIONS:N/ANOTE: 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.NoneI certify that the entries on these pages are accurate and complete.HILLARY PLATTE8/25/2021Appointing 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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