Audit & Reimbursement III (US

Position: Audit & Reimbursement III (US)
Audit & Reimbursement III

Location:

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
* Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

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.

The Audit & Reimbursement III is responsible for completing limited and full desk reviews on teaching, organ acquisition hospitals and other complex provider cost reports.

How you will make an impact:

* Plans, directs and controls specific provider audits.

* In charge auditor on large and/or complex field audits.

* Responsible for assigning, reviewing, and approving the work performed by auditors on team audits.

* Responsible for completing interim rate reviews final settlements and tentative settlements as assigned.

* 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.

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

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

* May perform Part A provider enrollment responsibilities as needed.

* Associates in this role are expected to maintain continuing education requirements.

Minimum Requirements:

* 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 Skills, Capabilities and Experiences:

* 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.

* A valid driver's license and the ability to travel to worksite and other locations as necessary.

For candidates working in person or virtually in the below location(s), the salary
* range for this specific position is $61,560 to $102,060

Locations:
Maryland, Minnesota, Nevada, and New York

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…