Audit & Reimbursement III

Elevance Health; Houston (TX); Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare management company is seeking an Audit & Reimbursement III to support Medicare audits. This role requires analyzing data, preparing detailed work papers, and conducting complex cost report audits. Ideal candidates will have a BA/BS degree and at least 5 years of experience in audit or related fields. The position offers maximum flexibility with virtual work options.

Qualifications

• Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience.
• Knowledge of CMS program regulations and cost report format preferred.
• Must obtain Continuing Education Training requirements (where required).

Responsibilities

• Analyzes and interprets data and makes recommendations for change based on judgment and experience.
• Prepares detailed work papers and presents findings in accordance with Government Auditing Standards.
• Performs complex cost report audits, serving as an in-charge auditor.

Skills

Data analysis

Time management

Problem-solving

Project management

Education

BA/BS degree

Degree in Accounting

Tools

Microsoft Office Word

Microsoft Excel

Job description

Audit & Reimbursement III- Medicare Cost Report Audit

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.

National Government Services is a proud member of Elevance Health’s family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.

The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government. Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement.

How you will make an impact:

• 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.
• 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.
• 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.
• Assist in mentoring less experienced associates as assigned.
• Perform complex cost report desk reviews.
• Perform complex cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit.
• Dependent upon experience, may perform supervisory review of work completed by other associates.
• Analyze and interpret data per a provider’s trial balance, financial statements, financial documents, or other related healthcare records.

Minimum Requirements:

• 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 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 Skills, Capabilities, and Experiences:

• 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.

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.