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Audit & Reimbursement Sr

  • Job Family: Audit
  • Type: Full time
  • Date Posted:
  • Req #: JR37713

Location:

  • National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
  • NY, East Syracuse
  • IN, Indianapolis
  • ME, South Portland

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Description

Audit & Reimbursement Senior

This is a remote position open nationwide

Primary Purpose: This position reports to the National Government Services, Inc. subsidiary. The Audit and Reimbursement Senior, will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).   The Audit and Reimbursement Senior will support contractual workload involving complex Medicare cost reports and Medicare Part A reimbursement.  This position provides a valuable opportunity to gain advanced experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities.

Responsible for all activities of an audit team

Primary duties may include, but are not limited to:

  • Evaluate the work performed by other associates to ensure accurate reimbursement to providers
  • Assist Audit and Reimbursement Leads and Managers in training, and development of other associates
  • Participates in special projects as assigned
  • Able to 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
  • Analyze and interpret data with recommendations based on judgment and experience
  • Must be able to perform all duties of lower level positions as directed by management
  • Participate in development and maintenance of Audit & Reimbursement standard operating procedures
  • Participate in workgroup initiatives to enhance quality, efficiency and training
  • Participate in all team meetings, staff meetings, and training sessions
  • Assist in mentoring less experienced associates as assigned
  • Prepare and perform supervisory review of cost report desk reviews and audits
  • Review of complex exception requests and CMS change requests
  • Perform supervisory review of workload involving  complex areas of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing and Allied Health, Organ Acquisition, Wage Index and all cost based principles

Minimum Qualifications:

  • Requires a BA/BS and a minimum of 8 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 Qualifications:

  • Degree in Accounting or other Business related degree
  • Demonstrated leadership experience preferred
  • Knowledge of Microsoft Word and Excel
  • A valid driver's license and the ability to travel may be required

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $70,960 to $127,728

Locations:  Colorado; Nevada, Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.  The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.


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.ElevanceHealth.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 ability@icareerhelp.com for assistance.

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