Audit and Reimbursement Lead

1 week ago


Marquand, Missouri, United States Elevance Health Full time
Audit and Reimbursement Lead - Quality Assurance

Elevance Health is seeking a highly skilled Audit and Reimbursement Lead to join our Quality Assurance team. As a key member of our team, you will be responsible for providing technical direction, workload planning, and operational support on a day-to-day basis. Your expertise will be essential in examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines.

Key Responsibilities:
  • Review and ensure compliance with regulations and company guidelines
  • Provide technical direction and workload planning
  • Operational support and mentoring of associates
  • Complex case research and resolution
  • Support the Appeal Unit with appeal issues
  • Participate in special projects and review of work done by lower-level auditors
  • Analyze and interpret data to make recommendations for change
  • Work independently with minimal guidance from management
Requirements:
  • BA/BS degree and a minimum of 8 years audit/reimbursement or related Medicare experience
  • Previous experience at a Senior Auditor level in health care, public accounting, or a government agency
  • Extensive knowledge of CMS principles, law, and regulations
Preferred Skills:
  • Accounting degree
  • Experience with software used to file and finalize cost reports
  • Demonstrated leadership experience
  • Knowledge of CMS computer systems and Microsoft Office Word and Excel

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. The salary range for this position is $86,320 to $135,954. Please note that the salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company.



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