Audit & Reimbursement II- Appeals
Elevance Health

Audit & Reimbursement II-Appeals

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 II 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 II will gain experience on the Medicare cost report and Medicare Part A Reimbursement. They will receive training to participate in contractual workload, along with opportunities to participate on special projects. This position provides a valuable opportunity to gain 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.

How you will make an impact:

• Analyze and interprets data and makes recommendations for change based on their judgment and experience.

• 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.
• Perform cost report desk reviews.
• Analyze and interpret data per a provider's trial balance, financial statements, financial documents, or other related healthcare records.
• Perform cost report reopenings.
• Under guided supervision, participate in completing appeals related work:
  • Position papers
  • Jurisdictional Reviews
  • Maintaining accurate records by updating all logs, case files, tracking systems
  • Participate in all team meetings, staff meetings, and training sessions

Minimum Requirements:

• Requires a BA/BS degree in Finance/Accounting/Business.
• 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:

• Degree in Accounting preferred.
• Knowledge of CMS program regulations and cost report format preferred.
• Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
• MBA, CPA or CIA preferred.
• Must obtain Continuing Education Training requirements (where required).
• A valid driver's license and the ability to travel may be required.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $54,400 - $85,680

Locations: Nevada, Maryland, and New York

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). 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.

* 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, 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.

---