Audit & Reimbursement III- PS33085

Audit & Reimbursement III- PS33085Location: United StatesNewRequisition #: PS33085Your Talent. Our Vision. At National Government Services (NGS) , an independent subsidiary of Anthem, Inc. and

one of the largest Medicare contractors in the country, it’s a powerful

combination. It’s the foundation upon which we’re creating greater

access to care for our members, greater value for our customers and greater

health for our communities. Join us and together we will drive thefuture of health care .This is an exceptional

opportunity to do innovative work that means more to you and those we

serve.NGS Audit &Reimbursement Auditor IIIWork Location – NGSLocations:Indianapolis IN,Syracuse NY,Portland ME,Richmond, VARemote may be considered

Responsible for completing limited and full deskreviews on teaching, organ acquisition hospitals and other complex providercost reports.

Primary duties may include, but are not limitedto: Plans, directs and controls specific provider audits. In charge auditor onlarge and/or complex field audits.

Responsible for assigning, reviewing, and approvingthe work performed by auditors on team audits.

Responsible for completing interim rate reviewsfinal settlements and tentative settlements as assigned. Will support theAppeal Unit with appeal issues as assigned.

Participates in special projects and review ofwork done by lower level auditors as assigned .

Performs complex calculations related to paymentexception requests and reviews exception request workpapers prepared by others.

Analyzes and interprets data and makesrecommendations for change based on judgment and experience.

May perform Part A provider enrollmentresponsibilities as needed. Must be able to perform all duties of lower levelpositions as directed by management.

NGS Audit & Reimbursement III- PS33085Requirements :Requires a BA/BS degree, preferably in

accounting; 5-7 years of audit/reimbursement or related Medicare experience;

thorough knowledge of CMS program regulations and cost report format; excellent

knowledge of CMS computer systems and Microsoft Office Word and Excel; or any

combination of education and experience, which would provide an equivalent

background. 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.