It sounds like you will be doing third-party audits. Most likely for Fiscal Intermediaries (FI). The FI are the enitities set up by insurance companies that actually do the Medicare work- CMS only provides the money. Depending on the firm, there could def be some compilation work involved, but many firms tend to shy away from doing compilations when they specialize in audits. The contracts come in pretty big lists and it doesn't look good to the FI when you get a contract and have to go back to them with a list of firms that you can't do because you're conflicted out. The audits are all to Yellowbook spec, so the conflict standards are extremely high.
My public firm does a TON of third party audits, desk reviews, and agreed-upon-procedures. For perspective, I think we have one annual compilation. The work is definitely specialized in that there are a lot of regs to apply in the course of the audit, but the the fundamental financial & Yellowbook auditing (GAAS & GAGAS) and technical skills are used. I know that the associates that jump ship where I am generally have no problem finding jobs outside the healthcare industry when & if they set their minds to it.
A nice benefit is that the firms that specialize in this stuff tend to get quite a bit of forensic accounting & litigation consulting work to keep you interested. It's extremely technical and rife with fraud, so any case generally needs a consulting CPA, if not an “Expert” CPA (an expert is qualified by the court). In any other industry, you could audit for 10 years and never find fraud. If you work in healthcare, you'll see it with some degree of regularity.
We get enough of the forensic work at my firm that I'd say that 90% of my workload consists of forensic work at this point with the remaining ten being due diligence. It's pretty interesting work and you get to work with some very talented people who know the industry. I'm regularly working with U.S. Attorneys, private equity guys, and Ivy League MBAs.
Another career path includes performing due diligence in mergers and acquisitions. Revenue assumptions are a little more complex in healthcare and have a lot of variables. Knowledge of Medicare and Medicaid reimbursement is invaluable for this type of work.
As a side benefit, I've found that, when compared to traditional audit or tax, the workload is pretty stable so there aren't too many Saturdays spent in the office. I've never seen any two-day turnaround audits (like mentioned above) yet.
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