Audit & Reimbursement III

Elevance Health; Providence (RI); Remote; USD 80,000 - 100,000; Full time

Job summary

A national healthcare services provider is hiring an Audit & Reimbursement III to analyze and support Medicare Cost Report Audits. Candidates should have a BA/BS degree and a minimum of 5 years' experience in audit/reimbursement. Responsibilities include preparing detailed work papers and conducting complex audits, with a preference for candidates knowledgeable in CMS regulations. The position offers flexibility as it enables remote work, with some in-person training required.

Qualifications

• 5 years of audit/reimbursement or related Medicare experience.
• Experience with Medicare cost reporting and reimbursement.
• Knowledge of CMS program regulations.

Responsibilities

• Analyze and interpret data; make recommendations.
• Prepare detailed work papers and present findings.
• Conduct complex cost report audits.

Skills

Analytical skills

Independent work

Time management

Project management

Problem-solving

Education

BA/BS degree

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.