Audit & Reimbursement III
This is a remote position open nationwide
Primary Purpose: The Audit and Reimbursement Auditor III will support audit activities of healthcare providers’ financial and statistical records in accordance with Government Auditing Standards (GAS). The Auditor III will be responsible for the auditing activities associated with performing audits and desk reviews of increasingly more difficult provider cost reports as part of our Medicare Administrative Contract (MAC) with the Federal Government (The Centers for Medicare and Medicaid Services (CMS) branch of the Department of Health and Human Services). The auditor will receive training, participate in audit related workload, mentor, and have opportunities to participate on special projects.
Responsible for completing more complex Audit & Reimbursement functions
Primary duties may include, but are not limited to:
- Responsible for completing limited and full desk reviews on complex provider cost reports
- In charge auditor on large and/or complex audits
- Perform supervisory review on less complex Medicare cost reports
- Analyze and interpret data per a provider’s trial balance, financial statements, financial documents or other related healthcare records
- Analyzes and interprets data and makes recommendations for change based on judgment and experience.
- Able to work independently on assignments and under minimal guidance from the manager
- Document findings, prepare detailed work papers and present audit adjustment reports in accordance with 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
- Must be able to perform all duties of lower level positions as directed by management
- Participates in special projects and review of work done by auditors as assigned
- Mentor staff as assigned
- 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 FGS (Federal 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 or other Business related degree
- Knowledge of CMS program regulations, cost report format, and CMS computer systems preferred
- A valid driver's license and the ability to travel may be required
- Knowledge of Microsoft Word and Excel
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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. Applicants who require accommodation to participate in the job application process may contact firstname.lastname@example.org for assistance.