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.
NGS Audit and Reimbursement Sr.
Preferred locations: Indianapolis, IN; South Portland, ME; East Syracuse, NY; Richmond, VA; open to work from home for the right candidate.
Audit & Reimbursement Senior position 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. The use of this job is limited to the National Government Services business unit.
The Audit and Reimbursement Senior will support audit activities of healthcare providers’ financial and statistical records in accordance with Government Auditing Standards (GAS). The Senior Auditor will be responsible for the auditing activities associated with performing audits and desk reviews of more difficult provider cost reports 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 as well as work on special projects as assigned.
Primary duties may include, but are not limited to:
- Complete the Uniform Desk Review/Audit Program on provider submitted Medicare cost reports for more complex providers
- 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 in accordance with GAS and CMS requirements
- Analyze and interpret data per a provider’s trial balance, financial statements, financial documents or other related healthcare records
- Stay abreast with applicable Federal Laws, regulations, policies and audit procedures
- Must be able to perform all duties of lower level positions as directed by management.
- Ability to use effective communication and interaction skills
- Ability to multi- task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills
- Mentor new and less experienced staff
- Requires a BA/BS degree (preferably in Accounting, Finance, Business Administration, or Healthcare Management) with 5+ years of Medicare cost report experience, or 8+ years of MAC audit/reimbursement experience or related Medicare cost report experience
- A valid driver's license and the ability to travel may be required
- Demonstrated understanding of accounting principles, auditing theories, or math concepts obtained through formal education and/or work related experience
- Must possess effective verbal and written communication skills
- Experience in Microsoft Office Word, Excel, and Outlook
- Effective organization and time management skills
- Effective problem solving skills
- Excellent interpersonal skills with the ability to establish working relationships with individuals at varying levels within the organization
- Ability to work remotely or sit onsite in one of the locations listed: Indianapolis, IN; South Portland, ME; East Syracuse, NY; Richmond, VA
The skills/competencies listed below are preferred but not required:
- 8+ years of Medicare audit/reimbursement or related Medicare experience
- Thorough knowledge of Medicare Part A Laws, regulations, program manuals and audit policies
- Thorough knowledge of CMS computer systems
- Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) or CPA Eligible
Applicable to Colorado Applicants Only
Annual Salary Range*: $69,040 - $86,300
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.