Job Details

ID #2729153
State California
City Westcovina
Full-time
Salary USD TBD TBD
Source Anthem
Showed 2019-09-24
Date 2019-09-25
Deadline 2019-11-23
Category Et cetera
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Audit & Reimbursement II

California, Westcovina 00000 Westcovina USA

Vacancy expired!

Audit & Reimbursement IILocation: United StatesNewRequisition #: PS27935Your 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.Audit & Reimbursement IIAudit & Reimbursement II

Responsible for completing limited and full desk reviews on providers as

assigned. Primary duties may include, but are not limited to:

Performs audit work scoped by the

desk reviews and will be the in-charge auditor on small and less complex

audits. - Assists higher level auditor on field work and appeals as assigned. -

Responsible for completing interim rate reviews, tentative settlements and

final settlements of providers as assigned. - Performs special audits of End Stage

Renal Disease (ESRD) providers and provider exception requests as assigned.

Updates STAR, FISS and PSF as assigned. - Participates as a team member on

audits of provider's records and other projects. - Analyzes and interprets data

and makes recommendations for change based on their judgment and experience. -

May perform Part A provider enrollment responsibilities as needed. - Must be

able to perform all duties of lower level positions as directed by management.

Preferred experience/duties include - Cost of care report Appeals experience

preferred.

Requirements:BA/BS degree,

preferably in accounting; 2-5 years of audit/reimbursement or related Medicare

experience; thorough knowledge of CMS program regulations and cost report

format; 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 or CIA preferred.Must obtain

Continuing Education Training requirements (where required). - Must have a

valid driver's license and the ability to travel occasionallyis required.Anthem,Inc. is ranked as one of America’s Most Admired Companies among health insurersby Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company forDiversity. To learn more about our company and apply, please visit us atantheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran

Vacancy expired!

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