Audit & Reimbursement II
Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
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 , under guided supervision, will support audit activities of healthcare providers' financial and statistical records in accordance with Government Auditing Standards (GAS). The Auditor II will gain experience on Medicare Part A Audit and Reimbursement as part of our Medicare Administrative Contract (MAC) with the Federal Government (The Centers for Medicare and Medicaid Services (CMS) branch of the Department of Health and Human Services). The auditor will receive training, participate in our Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain exposure in the healthcare reimbursement and financial industry. Entry level position responsible for basic Audit & Reimbursement functions.
How you will make an impact:
Analyzes and interprets data and makes recommendations for change based on their judgment and experience.
Interacts with the provider community and provider consultants regarding payments to providers, etc.
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.
Responsible for completing limited and full desk reviews on providers as assigned.
Performs audit work scoped by the S-10 desk reviews and will be the in-charge auditor on S-10 audits. Assists higher level auditor on audit work and appeals as assigned.
Perform supervisory review on less complex Medicare cost reports.
Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records.
Minimum Requirements:
Requires a BA/BS degree in Finance/Accounting/Business or any combination of education and related 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:
Degree in Accounting or other Business-related degree
Knowledge of Microsoft Word and Excel
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.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $53,580 to $88,830
Locations: Nevada, Minnesota, 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.
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.
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 and Influenza. 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 elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.