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. It provides maximum flexibility and autonomy. Candidates must be within a reasonable commuting distance from the posting location(s) 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 and Reimbursement II will support our Medicare Administrative Contract (MAC) with the federal government. Under guided supervision, the Audit and Reimbursement II will gain experience on the Medicare cost report and Medicare Part A Reimbursement. They will receive training to participate in contractual workload and special projects. This position provides a valuable opportunity to gain experience in auditing and financial analysis within a growing healthcare industry and offers educational opportunities leading to certifications, while promoting a well‑balanced lifestyle.

• 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, regulations, policies and audit procedures.
• Respond timely and accurately to customer inquiries.
• Multitask independently, effectively 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, tracking systems.
• Participate in all team meetings, staff meetings, and training sessions.

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

• 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 where required.
• Valid driver's license and ability to travel may be required.

For candidates working in person or virtually in the following locations, the salary range for this specific position is $53,580 to $88,830.

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

• The salary range reflects the company's assessment of possible compensation for this role at the time of posting. It may be modified in the future and actual compensation may vary by geographic location, work experience, education, and skill level.

In addition to your salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. Benefits are subject to eligibility requirements.

Elevance Health is an Equal Employment Opportunity employer. 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, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.