Audit & Reimbursement II- Appeals
Elevance Health is a health company dedicated to improving lives and communities, and they are seeking an Audit and Reimbursement II to support their Medicare Administrative Contract. The role involves analyzing data, preparing work papers, and participating in appeals related work under guided supervision, providing an opportunity to gain experience in auditing within the healthcare industry.
Responsibilities
- Analyze and interprets data and makes recommendations for change based on their judgment and experience
- 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
- 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 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
Skills
- Requires a BA/BS degree in Finance/Accounting/Business or any combination of education and related 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
- 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
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical, dental, vision, short and long term disability benefits
- 401(k) +match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Company Overview