Audit & Reimbursement II- Appeals

Audit & Reimbursement II-Appeals

Location:

Fully remote with required in‑person training sessions. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.

Base Pay Range

$53,580.00/yr - $88,830.00/yr

Overview

Position supports Medicare Administrative Contract (MAC) with the Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS). Under guided supervision, the Audit and Reimbursement II will gain experience in Medicare cost reporting, Part A reimbursement, and related financial analysis. The role offers opportunities to participate in contractual workload, special projects, and to obtain certifications that support professional growth.

How

You Will Make An Impact

• Analyze and interpret data and make recommendations for change 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 kill ensuring compliance.
• Respond timely and accurately to customer inquiries.
• Manage multiple tasks independently, prioritizing work with strong time‑management, initiative, project‑management, and problem‑solving skills.
• Analyze and interpret data from provider trial balances, financial statements, and other healthcare records.
• Perform cost‑report reopenings.
• Under guided supervision, participate in completing appeals related work: prepare position papers, jurisdictional reviews, and maintain accurate records by updating logs, case files, and tracking systems.
• Participate in all team meetings, staff meetings, and training sessions.

Minimum Requirements

• BA/BS degree in Finance, Accounting, Business, or equivalent combination of education and experience.
• Foreign nationals must satisfy CMS residency requirements of living in the United States for 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.
• Must obtain continuing education training requirements when required.
• A valid driver’s license and ability to travel may be required.

Government Business Division Requirements

If this job 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 Kasino functions, and sensitive data handling instructions.

Associates in these jobs must follow the specific policies, procedures, and guidelines as stated by the Government Business Division in which correlation they are employed.

Benefits

In addition to salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution. All benefits are subject to eligibility requirements and are designed to support professional growth and lifestyle balance.

Locations

Nevada, Minnesota, Maryland, Massachusetts, Columbus, Ohio and New York.

Equal Employment Opportunity Statement

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 elevancehealthjobssupport@  for assistance.

Qualified Applicants with Arrest or Conviction Records

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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