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　　Audit & Reimbursement III- Medicare Cost Report Appeals

　　Job Family: Audit

　　Type: Full time

　　Date Posted:Jan 18, 2024

　　Anticipated End Date:Feb 15, 2024

　　Reference: JR102198

　　Location:

　　IN, INDIANAPOLIS

　　MD, BALTIMORE

　　NJ, MORRISTOWN

　　WI, Waukesha

　　FL, MIAMI

　　OH, CINCINNATI

　　VA, RICHMOND

　　KY, LOUISVILLE

　　NY, NEW YORK

　　WA, SEATTLE

　　NH, MANCHESTER

　　TX, GRAND PRAIRIE

　　IL, CHICAGO

　　NY, EAST SYRACUSE

　　MI, DEARBORN

　　TX, DENISON

　　TN, NASHVILLE

　　NY, MIDDLETOWN

　　LA, METAIRIE

　　MN, GILBERT

　　DC, WASHINGTON

　　GA, MIDLAND

　　NV, LAS VEGAS

　　MN, MENDOTA HEIGHTS

　　TX, HOUSTON

　　VA, NORFOLK

　　MO, ST LOUIS

　　CT, WALLINGFORD

　　NC, CARY

　　MD, HANOVER

　　NJ, ISELIN

　　DE, WILMINGTON

　　OH, MASON

　　OH, SEVEN HILLS

　　RI, SMITHFIELD

　　CO, DENVER

　　MA, HINGHAM

　　NV, LAS VEGAS

　　PA, HARRISBURG

　　NC, WINSTON

　　ME, SOUTH PORTLAND

　　GA, ATLANTA

　　NY, LATHAM

　　OH, COLUMBUS

　　FL, TAMPA

　　IA, W DES MOINES

　　VA, ROANOKE

　　MA, WOBURN

　　Description

　　Audit & Reimbursement III- Medicare Cost Report Appeals

　　This is a virtual position, the ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

　　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.

　　Audit and Reimbursement III 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 III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further 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 :

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

　　Able to work independently on assignments and under minimal guidance from the manager.

　　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.

　　Must be able to perform all duties of lower-level positions as directed by management.

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

　　Assist in mentoring less experienced associates as assigned.

　　Dependent upon experience, may perform supervisory review of work completed by other associates.

　　Analyze and interpret data per a provider’s trial balance, financial statements, financial documents, or other related healthcare records.

　　Performs complex calculations related to payment exception requests and reviews exception request work papers prepared by others.

　　Perform cost report reopenings.

　　Under guided supervision, participate in completing more complex 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 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.

　　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 Qualifications:

　　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 $59,840 to $107,712

　　Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

　　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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

　　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. 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 [email protected] for assistance.

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　　Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.

　　EEO Policy Statement

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　　Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)

　　Need Assistance?

　　Email us ([email protected])