Vacancy caducado!
Audit & Reimbursement IILocation: United StatesNewRequisition #: PS27935Your 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 IIAudit & Reimbursement II
Responsible for completing limited and full desk reviews on providers as
assigned. Primary duties may include, but are not limited to:
Performs audit work scoped by the
desk reviews and will be the in-charge auditor on small and less complex
audits. - Assists higher level auditor on field work and appeals as assigned. -
Responsible for completing interim rate reviews, tentative settlements and
final settlements of providers as assigned. - Performs special audits of End Stage
Renal Disease (ESRD) providers and provider exception requests as assigned.
Updates STAR, FISS and PSF as assigned. - Participates as a team member on
audits of provider's records and other projects. - Analyzes and interprets data
and makes recommendations for change based on their judgment and experience. -
May perform Part A provider enrollment responsibilities as needed. - Must be
able to perform all duties of lower level positions as directed by management.
Preferred experience/duties include - Cost of care report Appeals experience
preferred.
Requirements:BA/BS degree,
preferably in accounting; 2-5 years of audit/reimbursement or related Medicare
experience; thorough knowledge of CMS program regulations and cost report
format; 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). - Must have a
valid driver's license and the ability to travel occasionallyis required.Anthem,Inc. is ranked as one of America’s Most Admired Companies among health insurersby Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company forDiversity. To learn more about our company and apply, please visit us atantheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran