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Audit & Reimbursement Specialist III
2 months ago
Audit & Reimbursement III Role
Elevance Health is seeking a highly skilled Audit & Reimbursement III to join our team. As a key member of our National Government Services division, you will play a critical role in supporting our Medicare Administrative Contract (MAC) with the federal government.
Key Responsibilities:
- Analyze and interpret 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.
- Dependent upon experience, may perform supervisory review of work completed by other associates.
- Analyze and interpret data per a provider's trial balance, financial statements, financial documents, or other related healthcare records.
- Perform cost report reopenings.
- Under guided supervision, participate in completing more complex appeals-related work: Position papers, Jurisdictional Reviews, Maintaining accurate records by updating all logs, case files, tracking systems, Participate in all team meetings, staff meetings, and training sessions.
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, Capabilities, and Experiences:
- 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).
- A valid driver's license and the ability to travel may be required.
Salary and Benefits:
The salary range for this position is $62,400 - $98,280. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements).
Work Environment:
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
Equal Employment Opportunity:
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.
