Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.
This positing is for future hiring.
The Audit & Reimbursement Lead will be 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).
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 Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.