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Anthem NGS Audit & Reimbursement III in Des Moines, Iowa

NGS Audit & Reimbursement III

Location: United States

Requisition #: PS17217

Post Date: Aug 15, 2019

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.

Position Location – Any NGS officeor work from home

The NGS Audit & ReimbursementIII is responsible for completing limited and full desk reviews on teaching, organ acquisition hospitals and other complex provider cost reports.

Primaryduties may include, but are not limited to:

· Plans, directs and controls specific provider audits. In charge auditor on large and/or complex field audits.

· Responsible for assigning, reviewing, and approving the work performed by auditors on team audits. Responsible for completing interim rate reviews final settlements and tentative settlements as assigned. Will support the Appeal Unit with appeal issues as assigned.

· Participates in special projects and review of work done by lower level auditors as assigned.

· Performs complex calculations related to payment exception requests and reviews exception request work papers prepared by others.

· Analyzes and interprets data and makes recommendations for change based on 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; 5-7 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.

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 is required.

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