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NGS Audit & Reimbursement II, Indianapolis, IN (PS6021) in Indianapolis, IN at Anthem, Inc.

Date Posted: 5/14/2018

Job Snapshot

Job Description

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. The use of this job is limited to the National Government Services business unit. If you believe this to be the best match for your position, please consult with your Human Resources partner prior to using this job (HRBP should work with Compensation). Responsible for completing limited and full desk reviews on providers as assigned. 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. 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. May perform Part A provider enrollment responsibilities as needed. Must be able to perform all duties of lower level positions as directed by management. 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.


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