Anthem Audit & Reimbursement Sr - open to any NGS location (PS3426) in Apple Valley, California

/ 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 & Reimbursement Sr –

Work Location: Any NGS office

Responsible for coordinating all activities of an audit or reimbursement team in the initiation and completion of assignments which includes acceptance, tentative settlements, interim rate reviews, completion of the desk audit review, field audit or in-house audit, and the settlement process of the CMS cost reports.

Primary duties may include, but are not limited to:

  • 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.
  • Review of wage index, MSP audits, complex exception requests and CMS change requests.
  • Assist the leads and managers in training and development of the staff on current CMS regulations.
  • Will support the Appeal Unit with appeal issues as assigned.
  • Participates in special projects and review of work done by lower level auditors as assigned.
  • Analyzes and interprets data and makes recommendations for change based on their judgment and experience.
  • Must be able to perform all duties of lower level positions as directed by management.
  • Provides oversight and leadership of the Part A provider enrollment function as needed.

    Bachelor degree required; Bachelor degree in Accounting preferred. MBA, CPA, CIA or CFE preferred. 8 years audit/reimbursement or related Medicare experience required. Must obtain Continuing Education Training requirements. Demonstrated leadership experience preferred. Thorough knowledge of CMS program regulations and cost report format required. Excellent knowledge of CMS computer systems and Microsoft Office Word and Excel required. Must be able to lift up to 25 pounds. Must have a valid driver's license and the ability to travel is required.

/ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran. /

Job Accounting/Finance/Auditing

Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

Title: Audit & Reimbursement Sr - open to any NGS location (PS3426)

Location: california-Apple Valley

Requisition ID: PS3426