Anthem, Inc. NGS Audit & Reimbursement Sr.-Office Based or remote (PS33132) in St. Louis, Missouri
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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.
Anthem has eight openings for the NGS Audit and Reimbursement Sr. role. 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
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.