Missouri Professional Services Jobs

Jobs.mo.gov mobile logo

Job Information

Anthem, Inc. Audit & Reimbursement III in St. Louis, Missouri


SHIFT: Day Job

SCHEDULE: Full-time

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. Audit & Reimbursement III PS31245

Location: Any NGS office or Work at home

This position is part of the Medicare Administrative Contract (MAC) with the Centers for Medicare and Medicaid Services (CMS). This position will support the Medicare part A Audit & Reimbursement department. This includes, but not limited to, processing provider submitted Medicare cost reports. The intent of this position is to support the Medicare cost report reopening workload, however it requires the ability to support all functions within the Audit & Reimbursement department. 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.

  • Responsible for completing Cost Report Reopenings for all provider types, mostly hospitals (including Critical Access) and SNFs.

  • Must have experience with Medicare Bad Debt reviews and Disproportionate Share Hospital (DSH) reimbursement.

  • Responsible for completing reviews on teaching, organ acquisition hospitals and other complex provider cost reports.

  • Participates in special projects and review of work done by lower level auditors as assigned, including training/mentoring of lower level auditors.

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

  • Will support the Audit Unit as assigned.


NGS Audit & Reimbursement III:


Requires a BA/BS degree, preferably in accounting; 5-7 years of audit/reimbursement or related Medicare experience; thorough knowledge of CMS program regulations and cost report format; excellent knowledge of CMS computer systems and Microsoft Office Word and Excel; or any combination of education and experience, which would provide an equivalent background. 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.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.