Elevance Health Audit & Reimbursement III-2 in HINGHAM, Massachusetts
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Audit & Reimbursement III-2
Job Family: Audit
Type: Full time
Date Posted:Nov 09, 2023
Req #: JR95267
ME, SOUTH PORTLAND
Audit & Reimbursement III
This is a hybrid position located within 50 mi of a NGS Elevance Health office (preferred locations (Indianapolis, IN, Denison, TX, Harrisburg, PA, Hingham, MA, Baltimore, MD, South Portland, ME, Cincinnati, OH, Richmond, VA, and Atlanta, GA)
This position reports to the National Government Services, Inc. subsidiary. The Audit and Reimbursement III 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). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further 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 completing more complex Audit & Reimbursement functions
Primary duties may include, but are not limited to:
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
Perform cost reopenings
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
Degree in Accounting or other Business related degree
Knowledge of Microsoft Word and Excel
Knowledge of CMS program regulations, cost report format, and CMS computer systems preferred
A valid driver's license and the ability to travel may be required
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. Requirements include but are not limited to 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. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
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.
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.
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
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 email@example.com for assistance.
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