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Audit & Reimbursement Senior

Location: OH
JobFamily: Accounting/Finance/Auditing
Req #: PS61760
Date Posted: Nov 29, 2021

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Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At National Government Services (NGS), an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country, it’s a powerful combination.  It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve. 

Audit and Reimbursement Sr.

This position can sit remotely nationwide. 

Responsible for coordinating all activities of an audit or reimbursement team in the initiation and completion of assignments which includes acceptance, tentative settlements, interim rate reviews, completion of the desk audit review, field audit or in-house audit, and the settlement process of the CMS cost reports. Primary duties may include, but are not limited to:

  • Perform audit work on complex audits.
  • Evaluate the work performed by the audit staff to assess the technical accuracy and accuracy of work papers and financial data related to the cost report.
  • Review of wage index, MSP audits, complex exception requests and CMS change requests.
  • Assist the leads and managers in training and development of the staff on current CMS regulations.
  • Will support the Appeal Unit with appeal issues as assigned.
  • Participates in special projects and review of work done by lower level auditors as assign.
  • Analyzes and interprets data and makes recommendations for change based on their judgment and experience.
  • Must be able to perform all duties of lower level positions as directed by management.
  • Provides oversight and leadership of the Part A provider enrollment function as needed.

Qualifications

This position supports Anthem’s federal contracting business, which is subject to the Covid-19 vaccination requirements set forth in Executive Order 14042 and its implementing guidance. Individuals performing work in this position must be able to prove they are fully vaccinated by providing required documentation. If you have a medical or sincerely held religious reason for not being vaccinated, consistent with applicable law, Anthem will consider requests for reasonable accommodation on this basis.  Should you have any questions regarding the requirement after applying, email [email protected].

Minimum Requirements: 

  • Requires a BA/BS, preferably in accounting and a minimum of 8 years of audit/reimbursement or related Medicare experience; or any combination of education and experience which would provide an equivalent background.

Preferred Requirements: 

  • Thorough knowledge of CMS program regulations and cost report format; excellent knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
  • Must obtain Continuing Education Training requirements.
  • MBA, CPA, CIA or CFE preferred.
  • Demonstrated leadership experience 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.

Applicable to Colorado Applicants Only

Annual Salary Range*: $70,960 - $88,700

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. 

* The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting.  The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future.  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, 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.

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.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.