Audit & Reimbursement III (US)

Audit & Reimbursement IIIThis role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities.How you will make an impact:Analyzes and interprets data and makes recommendations for change based on judgment and experience.Able to work independently on assignments and under minimal guidance from the manager.Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.Gain experience with applicable Federal Laws, regulations, policies and audit procedures.Respond timely and accurately to customer inquiries.Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills.Must be able to perform all duties of lower-level positions as directed by management.Participates in special projects and review of work done by auditors as assigned.Assist in mentoring less experienced associates as assigned.Job specific functions for Reopening Team:Review Medicare cost report re-openings initiated from provider requests, CMS requests, or by the MACPerform level 1 or level 2 audit review as part of the reopening process on all areas of the Medicare cost report such as Medicare DSH, Bad Debts, IME/DGME, NAH, Organ Acquisition and all cost based principlesAnalyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare recordsActively participate in development of Audit & Reimbursement standard operating proceduresActively participate in workgroup initiatives to enhance quality, efficiency and trainingMinimum Requirements:Requires a BA/BS degree and a minimum of 3 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background.This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.Preferred Skills, Capabilities and Experiences:Degree in Accounting or Finance preferred.Knowledge of CMS program regulations and cost report format preferred.Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.MBA, CPA or CIA preferred.Must obtain Continuing Education Training requirements (where required).A valid driver's license and the ability to travel may be required.If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions.For candidates working in person or virtually in the below location(s), the salary range for this specific position is $61,560 to $102,060:MarylandMinnesotaMassachusettsNevadaNew YorkColumbus, OhioIn addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.