Elevance Health
Audit & Reimbursement II-Appeals
Anticipated End Date: 2026-01-12
Position Title: Audit & Reimbursement II- Appeals
Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that candidates not within a reasonable distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.
National Government Services (NGS) is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the CMS to transform federal health programs.
About the Role The Audit and Reimbursement II will support our Medicare Administrative Contract (MAC) with the federal government. 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 interpret data and make recommendations for change based on 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 equivalent background through experience.
This position is part of our NGS division which 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.
Compensation and Benefits Salary range for this position is $53,580 to $88,830 based on location, experience, and qualifications. Elevance Health offers a comprehensive benefits package that includes 401(k) contribution, equity stock purchase, health, dental, vision, and other benefits.
EEO Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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Position Title: Audit & Reimbursement II- Appeals
Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that candidates not within a reasonable distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.
National Government Services (NGS) is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the CMS to transform federal health programs.
About the Role The Audit and Reimbursement II will support our Medicare Administrative Contract (MAC) with the federal government. 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 interpret data and make recommendations for change based on 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 equivalent background through experience.
This position is part of our NGS division which 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.
Compensation and Benefits Salary range for this position is $53,580 to $88,830 based on location, experience, and qualifications. Elevance Health offers a comprehensive benefits package that includes 401(k) contribution, equity stock purchase, health, dental, vision, and other benefits.
EEO Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
#J-18808-Ljbffr