Audit & Reimbursement Specialist

2 weeks ago


Atlanta, Georgia, United States Elevance Health Full time
About the Role

We are seeking a highly skilled Audit & Reimbursement Specialist to join our team at Elevance Health. As a key member of our organization, you will play a critical role in supporting our Medicare Administrative Contract (MAC) with the federal government.

Key Responsibilities
  • Analyze and interpret complex data to make recommendations for change based on judgment and experience.
  • 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.
  • Perform complex cost report desk reviews.
  • Perform complex cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit.
Requirements
  • Requires a BA/BS degree and a minimum of 5 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
  • Degree in Accounting 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).
About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


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