Government Audit Manager

Palmetto GBA, LLC; Birmingham, Northern (AL, KY); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401K retirement savings with company‑M

Life Insurance

PTO

On-site cafeterias and fitness centers

Wellness program

Tuition assistance

Employee discounts

Job summary

Palmetto GBA, LLC seeks a skilled audit manager to organize and direct audit teams handling healthcare compliance and CMS requirements. The role focuses on achieving production goals, developing policies, and guiding staff in line with company standards.

The position is full-time (40 hours/week), primarily on-site in Birmingham, AL, with consideration for strong remote candidates within the US. You will supervise staff, evaluate performance, and coordinate with CMS and other agencies.

Qualifications

• Bachelor's degree in Accounting, Finance, Business Administration, or related field.
• 5 years of operational/functional audits in healthcare.
• 2 years supervisory audit experience or equivalent military grade E4+.

Responsibilities

• Lead and organize audit work to meet timeliness and quality standards.
• Report results to management on a regular basis.
• Respond to provider questions and resolve disputed items.

Skills

Leadership

Analytical thinking

Communication

Problem solving

Interpersonal skills

Education

Bachelor's degree in Accounting/Finance/Business Administration

Tools

Microsoft Office

Job description

Summary Responsible for organizing the audit block into productive units or teams and directing the activities of the teams to meet the expectations of the department, the corporation, and the Centers for Medicare and Medicaid Service (CMS). Ensures workload production goals and standards are met and appropriate policies/work instructions are developed and communicated to staff. This is a full-time position working (40-hours/week) Monday-Friday. We are ideally considering candidates that can work on-site in Birmingham, AL or Columbia, SC but US-based remote candidates with strong credentials will be considered for the role.

What You’ll Do:

• Manages audit work to ensure appropriate flow of production is achieved within required timeliness standards.
• Reports results on a regular basis to management.
• Responds to provider questions on a wide range of audit topics and meets as necessary to resolve disputed items.
• Prepares instructions for staff to assist their understanding of Medicare regulations and company policies.
• Assists in the development of QMS instructions and programs and in the continued ISO certification of the unit.
• Communicates with and responds to inquiries from CMS and other government/external law enforcement agencies.
• Evaluates the composition of existing staff, interviews and hires new staff, completes annual performance evaluations, oversees promotional decisions, and shifts staff as needed to meet work requirements.
• Ensures audits are of sufficient quality and in compliance with all department, company, and CMS requirements through periodic review and inspection of work products.
• Responds to audit inquiries and findings produced by external reviewers.
• Performs special projects as assigned by management and expands working knowledge/technical skills.

To Qualify for This Position, You’ll Need:

• Bachelor's degree - Accounting, Finance, Business Administration, or other job-related field of study.
• 5 years experience in operational/functional audits within the healthcare industry.
• 2 years supervisory audit experience or equivalent military experience in grade E4 or above.
• Strong interpersonal skills and the ability to work professionally with persons at all levels.
• Ability to maintain effective working relationships.
• Ability to communicate clearly and effectively in oral and written form.
• Strong presentation, interviewing, and organizational skills with a strong attention to detail.
• Ability to make sound decisions.
• Strong knowledge of and proficiency in applying accounting principles and auditing standards.
• Strong knowledge of and proficiency in healthcare operational and financial systems.
• Ability to grasp and understand complex systems.
• Ability to analyze details and determine impact to corporation.
• Ability to understand management principles.
• Good planning, leadership, and human relations skills.
• Experience with Microsoft Office.

Preferred Qualifications:

• Medicare Cost Report audit experience.

What We can Do for You:

• Subsidized health plans
• dental and vision coverage
• 401K retirement savings plan with company match
• Life Insurance Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance Discounts to movies, theaters, zoos, theme parks and more

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Palmetto GBA is a healthcare service administrator and one of the nation’s largest providers of high-volume medical claims and transaction processing. We provide services and technology solutions to improve and streamline healthcare administration not only for government but also for corporate entities. We offer a wide range of services that require a diverse workforce and expansive areas of expertise from data analytics, administrative and workflow services to advanced systems. To help our associates succeed and reach their professional goal, we offer training classes and programs that help employees prepare for leadership positions and offer tuition assistance for education advancement. Palmetto GBA acknowledges associates’ hard work and dedication with awards and financial incentives.