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Audit & Reimbursement Sr

Company: Anthem, Inc
Location: Apple Valley
Posted on: December 28, 2019

Job Description:

Audit & Reimbursement Sr (PS 31496)Location: United StatesRequisition #: PS31246Post Date: Dec 11, 2019Your Talent. Our Vision. At National Government Services (NGS) , an independent subsidiary of Anthem, Inc. andone of the largest Medicare contractors in the country, its a powerfulcombination. Its the foundation upon which were creating greater accessto care for our members, greater value for our customers and greater health forour communities. Join us and together we will drive the future ofhealth care .This is an exceptional opportunity to doinnovative work that means more to you and those we serve.NGS Audit &Reimbursement Senior PS31496Work Location Any NGS office or Work from homeThis position is part ofthe Medicare Administrative Contract (MAC) with the Centers for Medicare andMedicaid Services (CMS). This position will support the Medicare part A Audit& Reimbursement department. This includes, but not limited to, processingprovider submitted Medicare cost reports. The intent of this position is tosupport the Medicare cost report reopening workload, however it requires theability to support all functions within the Audit & Reimbursementdepartment. These functions include but not limited to: Cost report acceptance,tentative settlements, rate reviews, desk reviews, audits, final settlements,reopenings, appeals and other compliance/reimbursement review.Primary dutiesapplicable to the Medicare cost report reopening workload include, but are notlimited to:

  • Review Medicare costreport re-openings initiated from provider requests, CMS requests, or by theMAC
  • Perform level 1 andlevel 2 audit review as part of the reopening process on all areas of theMedicare cost report such as Medicare DSH, Bad Debts, IME/DGME, NAH, OrganAcquisition and all cost based principles
  • Analyze and interpretdata with recommendations based on judgment and experience
  • Must be able to performall duties of lower level positions as directed by management
  • Actively participate indevelopment of Audit & Reimbursement standard operating procedures
  • Activity participate inworkgroup initiatives to enhance quality, efficiency and training
  • Participate on specialprojects as neededRequirements:Requires a BA/BS degree, preferably inaccounting; 8+ years of audit/reimbursement or related Medicare experience;thorough knowledge of CMS program regulations and cost report format; excellentknowledge of CMS computer systems and Microsoft Office Word and Excel; or anycombination of education and experience which would provide an equivalentbackground. Must obtain Continuing Education Training requirements. MBA, CPA,CIA or CFE preferred. Demonstrated leadership experience preferred. Must have avalid driver's license and the ability to travel is required.

Keywords: Anthem, Inc, Apple Valley , Audit & Reimbursement Sr, Accounting, Auditing , Apple Valley, California

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