Audit & Reimbursement III (US)
Elevance Health

Job Info

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Audit & Reimbursement III- S10

Location: This is a United States based, virtual position.

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-S10 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.

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
• Document findings, prepare detailed work papers and present audit adjustment reports in accordance with 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
• Mentor staff as assigned
• Responsible for completing limited and full desk reviews on complex provider cost reports
• In charge auditor on large and/or complex audits
• Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records
• Responsible for performing S-10 reviews and reviewing S-10 work completed by less experienced staff

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:

• S10 Experience
• Knowledge of Microsoft Word and Excel
• Degree in Accounting or other Business-related degree
• 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.

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