Cost Report Auditor Location: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin Job Description: Our Cost Report Auditor is responsible for conducting audits and desk reviews of Medicare Cost Reports in accordance with the Centers for Medicare & Medicaid Services (CMS) regulations. They ensure the accuracy and integrity of statistical and financial data submitted by healthcare providers and supports the effective use of U.S. tax dollars in the Medicare program. This auditor plays a key role in upholding government auditing standards and ensuring cost-effective healthcare delivery. Salary Range $47,000 - $51,000 The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience. Work Location We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin In this role you will: - Complete audits and desk reviews using the Uniform Desk Review/Audit Program, meeting established interim and monthly production goals. - Prepare audit adjustment reports and complete detailed work papers in alignment with Government Auditing Standards and CMS requirements. - Analyze financial and statistical data, including expense and revenue figures, to assess reasonableness and compliance with federal regulations. - Review provider pricing policies to ensure consistency in charge structures and examine statistical data for proper cost allocation. - Participate in work groups focused on improving work paper guidelines, auditing techniques, and documentation standards. - Communicate with providers providing explanations and supporting documentation and applicable regulations to support audit findings and reimbursement decisions. How do I know this opportunity is right for me? If you: - Thrive in a fast-paced environment that is deadline driven. - Are extremely detailed oriented and can identify inaccuracies easily. - Feel comfortable defending your decisions with data and facts. - Excel at math and problem solving. - Want to work in an environment with strong work life balance with flexible work hours. - Are interested in working remotely in the comfort of your home – no driving time, gas costs, or wear and tear on your vehicle. What will I gain from this role? - Work experience with a management team that is committed to maintaining a high performing work culture. - Learn basic auditing principles that can spark career growth. - A thorough introduction to healthcare reimbursement. - Serving Medicare beneficiaries and providers. - Working in a continuous performance feedback environment. Minimum Qualifications - Bachelor’s degree in Accounting, Finance, Business Administration, or related field, or equivalent post high school education and/or work-related experience. - Strong analytical and decision-making skills. - Exceptional organizational skills with a high degree of attention to details. - Strong verbal and written communication skills. - Solid knowledge and experience with Microsoft Excel. Preferred Qualifications - Knowledge of CMS Medicare Cost Reporting requirements and Government Auditing Standards. - Experience with audit methodologies, financial analysis, and regulatory compliance. Remote Work Requirements - Wired (ethernet cable) internet connection from your router to your computer. - High speed cable or fiber internet - Please review Remote Worker FAQs for additional information Benefits - Remote and hybrid work options available - Performance bonus and/or merit increase opportunities - 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately) - Competitive paid time off - Health insurance, dental insurance, and telehealth services start DAY 1 - Professional and Leadership Development Programs Who We Are WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready. Culture Drives Our Success WPS’ culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities. We are proud of the recognition we have received from local and national organizations regarding our culture and workplace: WPS Newsroom - Awards and Recognition. This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws.

Role Description As our Auditor, you will be a critical guardian of compliance and financial integrity, optimizing operational efficiency across our facility. Every day, you will conduct comprehensive audits of financial records, processes, and regulatory compliance. You’ll identify risks, evaluate internal controls, and provide insightful recommendations to enhance performance, mitigate fraud, and ensure adherence to healthcare laws, directly supporting sound decision-making. To be successful, you’ll combine strong analytical and investigative skills with an in-depth understanding of healthcare regulations, sharp attention to detail, and the ability to communicate complex findings persuasively, transforming audit insights into tangible improvements. - Performs prospective and concurrent chart reviews to ensure documentation is complete and compliant to facilitate the accurate reporting of HCC diagnoses via claims. - Works to resolve claims denials and reports denial trends to leadership. - Demonstrates analytical and problem-solving ability regarding review of submitted diagnosis codes versus services reflected in the documentation in the patients’ chart note. - Follows department policies and guidelines on appropriate documentation to billing codes, abstracting information from chart notes based on performance program measures. - Partners with the quality team, clinically integrated network and payers as necessary, to identify trends and gaps for creating a better process. - Assists in the development and reporting of HCC and Pay for Performance metrics. Qualifications - Five years physician coding experience. - Certified Rehabilitation Counselor, within 12 months. - Certified Professional Coder Hospital Apprentice, upon hire. - Certified Professional Coder Apprentice, upon hire. - Certified Coding Associate, upon hire. - Cardiology Coding, upon hire. - Certified Coding Specialist, upon hire. - Certified Coding Specialist - Physician Based, upon hire. - Certified Cardiovascular and Thoracic Surgery Coder, upon hire. - Certified Health Care Compliance, upon hire. - Certified Interventional Radiology Cardio Coder, upon hire. - Certified Professional Coder, upon hire. - Certified Professional Coder Hospital, upon hire. - Radiology Certified Coder, upon hire. - Registered Health Information Administrator, upon hire. - Registered Health Information Technician, upon hire. Requirements - Associates Other, upon hire. - Three years experience performing diagnosis, E/M, and procedure code audit/review/education functions for professional fees in multi-specialty setting. - Registered Nurse: TN, upon hire. - Licensed Practical Nurse: TN, upon hire. - Certified Nursing Assistant: TN, upon hire. - Certified Professional Medical Auditor, upon hire.

Title: IT Cloud Auditor Location: Hopkins, MN OR Charlotte, NC (Hybrid - 3 days On-site / 2 Remote) Job Description: Job#: 3032602 Duration: 9-12+ months - Potential to extend and/or convert FTE Large Banking Client Role Overview A Technology Risk Management team is seeking a motivated Senior Information Technology (IT) Auditor for its cloud control testing program. This role is integral to identifying and addressing compliance, financial, operational, and technology risks. The work requires proficiency in internal IT General Controls (ITGC) testing and IT auditing, with a focus on the planning and execution of cloud control testing and findings remediation. Key Responsibilities - Conduct comprehensive cloud IT control test planning for enterprise-wide infrastructure. - Perform reviews of control procedures and documentation, including conducting interviews to clarify processes and architectures. - Evaluate the design effectiveness of controls to ensure they mitigate the intended risks, with a focus on population validation. - Prepare test scripts using established templates, detailing the control narrative and referencing evidence documentation. - Independently execute end-to-end IT controls testing, from planning and evidence gathering to documenting results and submitting reports for review. - Identify control gaps, suggest improvements, and perform root cause and impact analysis. - Advise business partners on IT findings, risks, and control weaknesses. - Validate the remediation of identified findings to ensure effectiveness. - Maintain a current understanding of the cybersecurity footprint, platform architecture, and cloud infrastructure to support the review of processes and procedures. Required Qualifications Experience: - 5+ years of experience in Technology Audit and testing IT Controls, including ITGC and Cloud Security. - Demonstrated experience independently executing the full lifecycle of IT controls testing, including evaluating control design and operational effectiveness. - Extensive experience testing cloud controls in environments such as Azure and AWS. - Experience with control testing or audits against frameworks like PCI DSS, SOX, and SDLC. Technical Skills: - Ability to read and understand technical evidence such as screenshots, system logs, and scripts. - Understanding of control frameworks such as NIST, COBIT, or COSO. - Proven ability to work independently, meet deadlines, and produce clear, well-structured documentation. - Experience testing cloud controls - AWS/Azure Environments - Ability to read or write code in JSON, Python, or SQL for automation purpose Preferred Qualifications - CISA or CISSP certification. - Experience in the banking or financial services industry. We are an equal opportunity employer and welcome applications from all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico. Everforth Apex uses a virtual recruiter as part of the application process. Click here for more details. Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Everforth Apex team member can provide. Employee Type: Contract Location: Hopkins, MN, US Job Type: Infrastructure and Security Pay Range:$77 - $77 per hour

• Review medical bills to identify appropriate billing, coding, and savings opportunities. • Analyze and resolve claim discrepancies that require a deeper level of expertise beyond initial review. • Collaborate with the Negotiation team to resolve more complex claim issues and secure additional savings. • Communicate findings to clients through detailed Bill Review Reports and assist in discussing complex bill-related inquiries. • Evaluate and respond to bill reconsideration requests, including those requiring additional research or analysis. • Handle escalated provider inquiries, resolve disputes, and conduct direct negotiations for billing discrepancies. • Provide guidance and mentor junior analysts in claim review best practices. • Assist in identifying trends in billing issues, proposing system/process improvements, and contributing to policy development. • Support training efforts by educating internal teams and clients on changes to codes, edits, and bill review procedures. • Work cross-functionally with internal teams to identify and implement process efficiencies that improve savings and client satisfaction. • Ensure compliance with HIPAA and other regulatory standards. • Perform other duties as assigned.