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NGS Audit & Reimbursement II, Indianapolis, IN (PS6020) in Indianapolis, IN at Anthem, Inc.

Date Posted: 5/15/2018

Job Snapshot

Job Description

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.
Audit & Reimbursement II is responsible for completing limited and full desk reviews on providers as assigned.
This Position Is Located Onsite In Indianapolis, IN  
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.
  • Completes less complex desk reviews.
  • 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.
  • Must be able to perform all duties of lower level positions as directed by management.
Additional Duties
 
  • Prefer 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.
  • Thorough knowledge of Microsoft Office Word and Excel; or any combination of education and experience, which would provide an equivalent background. 
 
  • Requires a 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 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







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