Elevance Health
Overview
Anticipated End Date:
2025-10-27 Position Title:
Audit & Reimbursement II - Appeals Job Description: Audit & Reimbursement II - Appeals Location:
This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, 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 (CMS division of the Department of Health and Human Services). 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, along with opportunities to participate on special projects. This position provides a valuable opportunity to gain experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: Analyze and interprets data and makes recommendations for change based on their 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. Ability to multi- task while independently and 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
Minimum Requirements
Requires a BA/BS degree in Finance/Accounting/Business or any combination of education and related experience, which would provide an equivalent background This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities, and Experiences
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). A valid driver's license and the ability to travel may be required. Other Notes:
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. Salary Information
For candidates working in person or virtually in the below locations, the salary range for this specific position is $53,580 to $88,830. Locations: Nevada, Minnesota, Maryland, Massachusetts, and New York. Benefits and Equal Opportunity
Elevance Health offers a comprehensive benefits package and a range of rewards; details vary by location and eligibility. The salary offered is based on non-discriminatory factors and is subject to change. Elevance Health is an Equal Employment Opportunity employer and will consider all qualified applicants without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Job Level:
Non-Management Exempt Workshift:
1st Shift (United States of America) Job Family:
AFA > Audit, Comp & Risk Legal and Compliance
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
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Anticipated End Date:
2025-10-27 Position Title:
Audit & Reimbursement II - Appeals Job Description: Audit & Reimbursement II - Appeals Location:
This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, 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 (CMS division of the Department of Health and Human Services). 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, along with opportunities to participate on special projects. This position provides a valuable opportunity to gain experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: Analyze and interprets data and makes recommendations for change based on their 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. Ability to multi- task while independently and 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
Minimum Requirements
Requires a BA/BS degree in Finance/Accounting/Business or any combination of education and related experience, which would provide an equivalent background This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities, and Experiences
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). A valid driver's license and the ability to travel may be required. Other Notes:
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. Salary Information
For candidates working in person or virtually in the below locations, the salary range for this specific position is $53,580 to $88,830. Locations: Nevada, Minnesota, Maryland, Massachusetts, and New York. Benefits and Equal Opportunity
Elevance Health offers a comprehensive benefits package and a range of rewards; details vary by location and eligibility. The salary offered is based on non-discriminatory factors and is subject to change. Elevance Health is an Equal Employment Opportunity employer and will consider all qualified applicants without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Job Level:
Non-Management Exempt Workshift:
1st Shift (United States of America) Job Family:
AFA > Audit, Comp & Risk Legal and Compliance
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
#J-18808-Ljbffr