Anthem NGS Audit & Reimbursement Sr. Onsite NGS Office or Remote Opportunity (PS9453) in Shelbyville, Kentucky

NGS Audit & Reimbursement Sr. Onsite NGS Office or Remote Opportunity (PS9453)


Location: United States

Field: Accounting/Finance/Auditing

Requisition #: PS9453

Post Date: Jul 13, 2018

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.

The Audit & Reimbursement Sr is responsible for coordinating all activities of an audit or reimbursement team in the initiation and completion of assignments which includes acceptance, tentative settlements, interim rate reviews, completion of the desk audit review, field audit or in-house audit, and the settlement process of the CMS cost reports.

Primary duties may include, but are not limited to:

  • Perform audit and reimburse work on complex providers.

  • Evaluate the work performed by the audit staff to assess the technical accuracy and accuracy of work papers and financial data related to the cost report.

  • Review of wage index, MSP audits, complex exception requests and CMS change requests.

  • Assist the leads and managers in training and development of the staff on current CMS regulations.

  • Will support the Appeal Unit with appeal issues as assigned.

  • Participates in special projects and review of work done by lower level auditors as assign.

  • Analyzes and interprets data and makes recommendations for change based on their judgment and experience.

  • 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 of audit/reimbursement or related Medicare experience; thorough 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.

  • Must obtain Continuing Education Training requirements.

  • MBA, CPA, CIA or CFE preferred. Demonstrated leadership experience preferred.

  • Must have a valid driver's license and the ability to travel is required.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran