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Account Resolution Spec I

Noridian Healthcare Solutions
life insurance, vision insurance, paid holidays, sick time, 401(k), remote work
United States, North Dakota, Fargo
Mar 14, 2025
Description
* Position is eligible for Remote / Work from Home opportunity *
Department: Recoupment
Telecommuting Eligible: Yes
Job Grade: N13
Notice of Collection & Privacy Policy for Applicants Residing in California: California Applicant Privacy Policy | Noridian (noridiansolutions.com)
Job Title

Account Resolution Specialist I


Job Summary

The Account Resolution Specialist supports business initiatives through systems analysis and evaluation of Noridian business requirements as defined by the Centers for Medicare & Medicaid Services (CMS) regulations and other key clientele. This position navigates organization systems to generate commissioned reports ensuring the organization is completing tasks in a timely and to acceptable standards using tasks lists, data gathering, and open communication with external clients.


Key Performance Indicators

  • Strong communication and collaboration skills
  • Ability to research and analyze data from multiple sources
  • Prioritization and multi-tasking skills with high attention to detail


Essential Functions
Key Duties/Responsibilities/Accountabilities

  • Monitors system generated reports used to support key accounts and completes task lists to ensure departmental timeliness and performance standards are met
  • Documents and prepares reports for accuracy, timeliness, or system issues to identify patterns
  • Prepares documentation for new system releases, updates, and testing
  • Provides analysis of any requested data reports prior to various deadlines
  • Determines proper resources to gather information and details regarding department inquiries
  • Utilizes internal and external resources, system support, and databases to gather and address specific settlement details, inquiries, and system issues
  • Clearly documents sources and validates the accuracy of data/information to resolve inconsistencies
  • Review financial reconciliation reports submitted to CMS and other department appointed accounts on a monthly, quarterly, and annual basis
  • Collaborates with external entities to progressively resolve escalated collections
  • Reviews untimely debt and initiates the debt collection services from the United States (US) Department of Treasury
  • Provides status of financial condition of the Medicare trust fund by collecting, interpreting, and reporting key financial data
  • Determines approval or denial of supplier's requests for extended repayment (ERS) after reviewing the suppliers financial documents, Medicare history, and ERS history
  • Fosters relationships with primary accounts and maintains a collaborative understanding
  • Monitors all overpayments identified in the system and creates Intent to Refer letters to be sent to the US treasury
  • Analyzes CMS change requests and assists with the development of any changes or new processes that must be implemented to meet CMS requirements


Non-Essential Duties and Functions

  • Other duties as assigned


Minimum Qualifications

  • Associates degree in Accounting, Business or related field or equivalent combination of education, experience, or training as determined by HR (unless regulated by contract or program standards)


Preferred Qualifications
Above requirements and the following:

  • Bachelor's degree in Business or Accounting
  • Medicare operations experience
  • Strong communications skills


Environment and Cognitive/Physical Demands

  • Office Environment
  • Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
  • Requires prolonged sitting and telephone use
  • Requires the use of office equipment such as computer terminals, telephones, copiers and printers
  • Infrequent lifting to 15 pounds
  • Infrequent stooping


Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.


Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.


Total Rewards Package:

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.


CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

An employee in this position may be required to possess a "Federal Identification Card" (Federal ID) as a condition of employment. Federal ID's may include one of the following: Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.


Equal Employment Opportunity

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.


Other Information

Below is the salary range for potential new hires.

Salary Range: $17.75 - $27.25

Other Compensation: Self-Managed PTO (if applicable), Incentive Plan

Lifestyle Benefit: $50/month

This job will be closed 03/19/2025 at 8:00AM CST. No further applications will be considered.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
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