Andover, MA, United States
Audit & Reimbursement Lead- Any Anthem Office (PS11936)
Location: United States
Requisition #: PS11936
Post Date: 3 hours ago
Your Talent. Our Vision. At National 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 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.
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). A valid driver's license and the ability to travel may be required.
Anthem, Inc. is ranked as one ofAmerica’s Most Admired Companies among health insurers by Fortune magazine andis a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn moreabout our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
Website : http://www.antheminc.com
The company was formed when WellPoint Health Networks Inc. and Anthem, Inc. merged in 2004 to become the nation's leading health benefits company. The parent company originally assumed the WellPoint, Inc. name at the time of the merger. In December 2014, WellPoint, Inc. changed its corporate name to Anthem, Inc. The Anthem brand is built on a foundation of trust – it’s the name consumers are most familiar with as a trusted health care partner through our affiliated health plans. Anthem, Inc. is one of the largest health benefits companies in the United States. Through its affiliated health plans, Anthem companies deliver a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, Anthem, Inc. is an independent licensee of the Blue Cross and Blue Shield Association serving members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin; and specialty plan members in other states.