Audit & Reimbursement III - Training

Wellpoint Federal Solutions, Inc.; Indianapolis (IN); Hybrid; USD 66.000 - 105.000; Vollzeit

Benefits dieser Stelle

comprehensive benefits package

401k contribution

paid holidays

Paid Time Off

incentive bonus programs

medical

dental

vision

short and long term disability

401(k) +match

stock purchase plan

life insurance

wellness programs

Zusammenfassung

Wellpoint Federal Solutions, Inc. is seeking an Audit & Reimbursement III - Training professional to lead and deliver instructor‑led and virtual training for audit teams.

This role emphasizes developing relevant course content, conducting sessions, and overseeing provider audits within a hybrid/virtual work environment. Requirements include a BA/BS with 3+ years' Medicare audit experience and US residency for three of the last five years.

Qualifikationen

• BA/BS degree with 3+ years of audit/reimbursement or Medicare experience.
• Residency: United States resident for the past 3 of 5 years.

Aufgaben

• Collaborate with audit leaders to identify training topics and gaps.
• Develop course content and exercises relevant to audit practice.
• Lead virtual training sessions using audit experience to demonstrate processes.
• Plan and direct provider audits; oversee large/complex field audits.
• Review and approve work performed by auditors on the team.
• Participate in special projects and mentor junior auditors.
• Analyze data and recommend changes based on judgement and experience.
• Maintain continuing education requirements.

Kenntnisse

Audit experience

Training delivery

CMS HFS knowledge

MS Word

PowerPoint

Excel

Ausbildung

BA/BS degree

Accounting degree preferred

Tools

CMS HFS

Microsoft Office Word

PowerPoint

Excel

Jobbeschreibung

Audit & Reimbursement III - Training

Location: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Wellpoint Federal, a subsidiary of Elevance Health, brings deep industry expertise and healthcare service capabilities to support federal programs. The organization delivers solutions across claims administration, data, and care delivery to help address complex challenges and improve health outcomes for federal populations.

Responsibilities

• Works with audit leaders to spot skill gaps and prioritize topics to train on.
• Create course content and exercises; ensuring examples and guidance are relevant to current audit practice.
• Facilitate training sessions using audit experience to demonstrate processes and procedures.
• Plans, directs and controls specific provider audits.
• In charge auditor on large and/or complex field audits.
• Responsible for reviewing, and approving the work performed by auditors on team audits.
• Participates in special projects and review of work done by lower level auditors as assigned.
• Analyzes and interprets data and makes recommendations for change based on judgment and experience.

Associates in this role are expected to maintain continuing education requirements.

Minimum Requirements

• Requires a BA/BS degree and a minimum of 3 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 Wellpoint Federal 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

• Experience delivering engaging, instructor‑led training in a virtual environment preferred.
• Working knowledge of HFS (CMS computer system) and Microsoft Office Word.
• PowerPoint and Excel strongly preferred.
• Degree in Accounting preferred.
• Knowledge of CMS program regulations and cost report format preferred.
• MBA, CPA or CIA preferred.
• If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a “sensitive position” work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions, including more stringent and frequent background checks and/or government clearances, segregation of duties principles, role‑specific training, monitoring of daily job functions, and sensitive data handling instructions.

Salary & Locations

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $66,480 to $104,706.

• Maine
• Maryland
• Massachusetts
• NewYork

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)
• 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

Job Details

Job Level: Non-Management Exempt. Workshift: 1st Shift (United States of America). Job Family: AFA > Audit, Comp & Risk.

Company Culture

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Hybrid Workforce Strategy

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

COVID‑19 & Vaccination

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member‑facing roles to become vaccinated against COVID‑19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.

Equal Employment Opportunity

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, colour, 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.

Accessibility Accommodation

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

Background & Clearance

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Salary Details

*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, paid time off, stock, 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.

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.

Additional Information

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, colour, 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, and local laws. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.