Audit & Reimbursement II- Appeals

Audit & Reimbursement II-Appeals

Location:

This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. Candidates not within a reasonable commuting distance will not be considered unless an accommodation is granted.

Base pay range: $53,580.00 – $88,830.00 per year.

The Audit and Reimbursement II supports our Medicare Administrative Contract (MAC) with the Centers for Medicare and Medicaid Services (CMS). Under guided supervision, the role gains experience on the Medicare cost report and Medicare Part A reimbursement, participates in contractual workload and special projects, and offers opportunities for certifications and professional networking.

• Analyze and interpret data and make recommendations based on judgment and experience.
• Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.
• Gain experience with applicable Federal laws, regulations, policies and audit procedures.
• Respond timely and accurately to customer inquiries.
• Multi‑task while independently prioritizing work using time management, initiative, project management and problem‑solving skills.
• Analyze and interpret data per a provider’s trial balance, financial statements, financial documents or other related healthcare records.
• Perform cost report reopenings.
• Under guided supervision, participate in completing appeals‑related work: position papers, jurisdictional reviews, maintaining accurate records by updating all logs, case files and tracking systems.
• Participate in all team meetings, staff meetings and training sessions.

• BA/BS degree in Finance/Accounting/Business or equivalent combination of education and related experience.
• Foreign national applicants must meet residency requirement of living in the United States at least three of the past five years (per CMS TDL 190275).

• Degree in Accounting.
• Knowledge of CMS program regulations and cost report format.
• Knowledge of CMS computer systems and Microsoft Office Word and Excel.
• MBA, CPA or CIA.
• Must obtain Continuing Education Training requirements (where required).
• Valid driver’s license and ability to travel may be required.

In addition to your salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution. Salary is based on factors such as geographic location, work experience, education and skill level, and may be modified in the future.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Entry level

Full‑time

Accounting / Auditing and Finance

Industries:
Accounting