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Audit & Reimbursement Specialist

2 months ago

Marquand, Missouri, United States Elevance Health Full time
About the Role

We are seeking a highly skilled and detail-oriented Audit & Reimbursement III to join our team at Elevance Health. As a key member of our Medicare Administrative Contract (MAC) team, you will support our federal government contracts and partner with the Centers for Medicare and Medicaid Services (CMS) to transform federal health programs.

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 to 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 and demonstrate ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management, and problem-solving skills.
  • Perform complex Medicare cost report desk reviews, audits, and reopenings, 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.
  • Microsoft Office Excel strongly preferred.
  • Knowledge of CMS computer systems preferred.
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.