Audit & Reimbursement II
About The Position
The Audit & Reimbursement II reviews and processes appeal mail intake within the HUB unit of the appeals team. The role supports federal programs and develops experience with applicable federal laws, regulations, policies, and audit procedures. Under guided supervision, the associate completes appeals-related work, including position papers and jurisdictional reviews, and assists higher-level auditors with field work and appeals as assigned. This is a virtual full-time role, with in-person training sessions required. Alternate locations may be considered for candidates within commuting distance of an office; candidates outside a reasonable commuting distance from the posting locations are not considered unless an accommodation is granted as required by law. The role is part of Wellpoint Federal, a subsidiary of Elevance Health.
Requirements
- A BA/BS degree in Finance, Accounting, or Business, or an equivalent combination of education and related experience.
- For foreign national applicants, residency in the United States for at least three of the past five years is required.
Nice To Haves
- Degree in Accounting.
- Knowledge of CMS program regulations and cost report format.
- Knowledge of CMS computer systems and Microsoft Office Word and Excel.
- MBA, CPA, or CIA.
Responsibilities
- Review and process appeal mail intake within the HUB unit of the appeals team.
- Gain experience with applicable federal laws, regulations, policies, and audit procedures.
- Respond to customer inquiries accurately and in a timely manner.
- Prioritize and manage multiple tasks independently using time management, initiative, project management, and problem-solving skills.
- Assist higher-level auditors with field work and appeals as assigned.
- Participate as a team member in provider records and other projects.
- Analyze and interpret data and recommend changes based on judgment and experience.
- Complete appeals-related work under guided supervision, including position papers and jurisdictional reviews.
- Maintain accurate records by updating logs, case files, and tracking systems.
- Participate in team meetings, staff meetings, and training sessions.
- Maintain continuing education requirements.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution and matching.
- Merit increases.
- Paid holidays.
- Paid time off.
- Incentive bonus programs, unless covered by a collective bargaining agreement.
- Medical insurance.
- Dental insurance.
- Vision insurance.
- Short- and long-term disability benefits.
- Life insurance.
- Wellness programs.
- Financial education resources.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
