Audit & Reimbursement Sr
Vacancy expired!
Description SHIFT: Day JobSCHEDULE: Full-timeYour 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 the future of health care.This is an exceptional
opportunity to do innovative work that means more to you and those we
serve. Audit & Reimbursement Sr –
PS39490Responsible for coordinating
all activities of an audit or reimbursement team in the initiation and
completion of assignments which includes acceptance, tentative settlements,
interim rate reviews, completion of the desk audit review, field audit or in-house
audit, and the settlement process of the CMS cost reports. Primary duties may include,
but are not limited to:
Perform audit work
on complex audits.
Evaluate the work
performed by the audit staff to assess the technical accuracy and accuracy of
work papers and financial data related to the cost report.
Review of wage
index, MSP audits, complex exception requests and CMS change requests. Assist
the leads and managers in training and development of the staff on current CMS
regulations.
Will support the
Appeal Unit with appeal issues as assigned.
Participates in
special projects and review of work done by lower level auditors as assign.
Analyzes and
interprets data and makes recommendations for change based on their judgment
and experience.
Must be able to
perform all duties of lower level positions as directed by management.
Provides oversight and leadership of the Part
A provider enrollment function as needed.
Qualifications Requirements:
Requires a BA/BS
degree, preferrably in accounting; 8+ 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. Must obtain Continuing Education Training
requirements. MBA, CPA, CIA or CFE preferred. Demonstrated leadership
experience preferred. A valid driver's license and the ability to travel may be
required.
Anthem, Inc. is ranked as one of
America’s Most Admired Companies among health insurers by Fortune magazine and
is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more
about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity
Employer/Disability/Veteran.REQNUMBER: PS39490
Vacancy expired!