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Audit & Reimbursement II or III

Company: Anthem, Inc
Location: Pembroke Pines
Posted on: March 17, 2020

Job Description:

Audit & Reimbursement II or III - PS33300Location: United StatesNewRequisition #: PS33300Post Date: 6 days agoYour Talent. Our Vision. At National Government Services (NGS) , an independent subsidiary of Anthem, Inc. andone of the largest Medicare contractors in the country, its a powerfulcombination. Its the foundation upon which were creating greateraccess to care for our members, greater value for our customers and greaterhealth for our communities. Join us and together we will drive thefuture of health care .This is an exceptionalopportunity to do innovative work that means more to you and those weserve.Audit & Reimbursement II orIII PS33300.Location: Any NGS office or May consider Work athomeThis position is part ofthe Medicare Administrative Contract (MAC) with the Centers for Medicare andMedicaid Services (CMS). This position will support the Medicare part A Audit& Reimbursement department. This includes, but not limited to, processingprovider submitted Medicare cost reports. The intent of this position is tosupport the Medicare cost report reopening workload, however it requires theability to support all functions within the Audit & Reimbursementdepartment. These functions include but not limited to: Cost report acceptance,tentative settlements, rate reviews, desk reviews, audits, final settlements,reopenings, appeals and other compliance/reimbursement review.

  • Responsiblefor completing Cost Report Reopenings for all provider types, mostlyhospitals (including Critical Access) and SNFs.
  • Must haveexperience with Medicare Bad Debt reviews and Disproportionate ShareHospital (DSH) reimbursement.
  • Position will concentrate oncost report appeals
  • Responsiblefor completing reviews on teaching, organ acquisition hospitals and othercomplex provider cost reports.
  • Participatesin special projects and review of work done by lower level auditors asassigned, including training/mentoring of lower level auditors.
  • Must be ableto perform all duties of lower level positions as directed by management.
  • Will supportthe Audit Unit as assigned.NGS Audit &Reimbursement II - PS33300Requirements:
    • BA/BSdegree, preferably in accounting; 2-5 years of audit/reimbursement or relatedMedicare experience; thorough knowledge of CMS program regulations and costreport format; knowledge of CMS computer systems and Microsoft Office Word andExcel; or any combination of education and experience, which would provide anequivalent background.
    • MBA, CPA or CIA preferred.NGS Audit &Reimbursement III - PS33300Requirements :
      • Requiresa BA/BS degree, preferably in accounting; 5-7 years of audit/reimbursement orrelated Medicare experience; thorough knowledge of CMS program regulations andcost report format; excellent knowledge of CMS computer systems and MicrosoftOffice Word and Excel; or any combination of education and experience, whichwould provide an equivalent background. MBA, CPA or CIA preferred.
      • Mustobtain Continuing Education Training requirements (where required).
      • A valid driver's license and the ability totravel may be required.

Keywords: Anthem, Inc, Pembroke Pines , Audit & Reimbursement II or III, Accounting, Auditing , Pembroke Pines, Florida

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