Your Talent. Our Vision. AtNational Government Services (NGS),an independent subsidiary of Anthem, Inc. and one of the largest Medicare contractors in the country, it's a powerful combination. It's the foundation upon which we're creating greater care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.
TheAudit & Reimbursement Lead (NGS)position is responsible for providing technical direction, workload planning, associate mentoring and operational support on a day-to-day basis. Primary duties may include, but are not limited to:
Reviews work of the associates to ensure they are following the appropriate guidelines, provides training both in a formal and informal setting, reviews the policies and procedures to make sure they are appropriate, and monitors workload inventory to ensure timely completion.
Handles complex case research and resolutions.
Will support the Appeal Unit with appeal issues as assigned.
Participates in special projects and review of work done by lower level auditors.
Analyzes and interprets data and makes recommendations for change based on their judgment and experience.
Able to work independently on assignments and under minimal guidance from the manager.
Monitors inventory to ensure workflow remains uninterrupted.
Assists management with workload and financial budget responsibilities.
Must have extensive knowledge of CMS principles, law and regulations.
Works with management on interaction with internal and external audits and performance measures.
Assists in ISO certification activities.
Must be able to perform all duties of lower level positions as directed by management.
Requires a BA/BS degree, preferably in Accounting; 8 years audit/reimbursement or related Medicare experience; previous experience at a Senior Auditor level in health care, public accounting or a government agency; experience in software used to file and finalize cost reports; experience with paperless audit software applications; demonstrated leadership experience; through knowledge of CMS program regulations and cost report format; excellent knowledge of CMS computer systems and Microsoft Office Word and Excel; or any combination of education and experience, which would provide an equivalent background.
MBA, CPA, CIA or CFE preferred.
Must obtain Continuing Education Training requirements (where required).
Must have a valid driver's license and the ability to travel is required.
/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 functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed./
/ Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /
Title: Audit & Reimbursement Lead (NGS) - 123064
Other Locations: ME-South Portland, United States, NY-Syracuse, IN-Indianapolis
Requisition ID: 123064
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