Anthem Inc. Virginia Jobs

Job Information

Anthem, Inc. Audit & Reimbursement III/Senior (S10) in Norfolk, Virginia

Description

SHIFT: Day Job

SCHEDULE: Full-time

Be part of an extraordinary team

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Please Note: This position may be filled at either the Audit & Reimbursement III (S10) or Audit & Reimbursement Senior (S10) level. Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position. This position is remote open nationwide.

Audit & Reimbursement III (S10)

The Audit & Reimbursement III (S10) is responsible for completing limited and full desk reviews on teaching, organ acquisition hospitals and other complex provider cost reports including, but not limited to, S10.

Primary duties may include, but are not limited to:

  • Plans, directs and controls specific provider audits including, but not limited to, S10.

  • In charge auditor on large and/or complex field audits.

  • Responsible for assigning, reviewing, and approving the work performed by auditors on team audits.

  • Responsible for completing interim rate reviews final settlements and tentative settlements as assigned.

  • Will support the Appeal Unit with appeal issues as assigned.

  • Participates in special projects and review of work done by lower level auditors as assigned.

  • Performs complex calculations related to payment exception requests and reviews exception request workpapers prepared by others.

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

  • May perform Part A provider enrollment responsibilities as needed.

Audit & Reimbursement Senior (S10)

This is a remote position open nationwide

The Audit & Reimbursement Senior (S10) is responsible for coordinating all activities of an S10 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 including, but not limited to, S10.

  • 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.

  • Provides oversight and leadership of the Part A provider enrollment function as needed.

Qualifications

Audit & Reimbursement III (S10)

Minimum Qualifications:

  • 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.

Preferred Qualifications:

  • Degree in Accounting preferred.

  • Knowledge of CMS program regulations and cost report format preferred including, but not limited to, S10.

  • 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.

Audit & Reimbursement Senior (S10)

Minimum Qualifications:

  • Requires a BA/BS 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 Qualifications:

  • Accounting degree preferred.

  • Knowledge of CMS program regulations and cost report format preferred including, but not limited to, S10.

  • 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.

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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem 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 ability@icareerhelp.com for assistance.

REQNUMBER: PS68686-Virginia%20Beach

DirectEmployers