Audit & Reimbursement II

Elevance Health•Indianapolis, IN

1d•Remote

About The Position

The Audit & Reimbursement II reviews and processes appeal mail intake within the HUB unit of the appeals team at Wellpoint Federal, a subsidiary of Elevance Health. The role supports federal programs and provides associates with experience in applicable federal laws, regulations, policies, and audit procedures. It is described as virtual full-time, except for required in-person training sessions. Candidates generally must live within a reasonable commuting distance of a posting office unless an accommodation is granted as required by law. The position works under guided supervision on appeals-related tasks, including position papers and jurisdictional reviews, and assists higher-level auditors with field work and appeals. Associates maintain accurate logs, case files, and tracking systems, respond to customer inquiries, analyze and interpret data, and contribute recommendations and project work. Continuing education and participation in meetings and training are expected.

Requirements

A BA/BS degree in Finance, Accounting, or Business, or an equivalent combination of education and related experience.
For foreign national applicants in the Wellpoint Federal division, 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.
Knowledge of 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 in a timely and accurate manner.
Prioritize and manage multiple tasks independently and effectively.
Assist higher-level auditors with field work and appeals as assigned.
Participate as a team member in provider records work and other projects.
Analyze and interpret data and make recommendations for change based on judgment and experience.
Under guided supervision, complete appeals-related work, 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.