Audit & Reimbursement III - Training
About The Position
The Audit & Reimbursement III designs, delivers, and continuously improves audit training so department staff can develop the skills needed to complete limited or full desk reviews of hospital and non-hospital providers. The role partners with audit leaders to identify skill gaps and prioritize training topics, creates relevant course content and exercises, and facilitates sessions using audit experience to demonstrate processes and procedures. The position also plans, directs, and controls provider audits; serves as the in-charge auditor on large or complex field audits; reviews and approves work performed by auditors on team audits; and participates in special projects and reviews of work performed by lower-level auditors as assigned. The role analyzes and interprets data, recommends changes based on judgment and experience, and maintains continuing education requirements. This is a primarily virtual full-time position, with required in-person training sessions. Applicants must be within a reasonable commuting distance of the posting location unless an accommodation is granted. The role is in Wellpoint Federal, a subsidiary of Elevance Health, and may carry additional sensitive-position requirements, including more stringent background checks or government clearances, role-specific training, monitoring, and sensitive-data handling procedures.
Requirements
- A BA/BS degree and at least 3 years of audit/reimbursement or related Medicare experience, or an equivalent combination of education and experience.
- For this Wellpoint Federal division position, foreign national applicants must have lived in the United States for at least three of the past five years.
Nice To Haves
- Experience delivering engaging, instructor-led training in a virtual environment.
- Working knowledge of HFS (CMS computer system) and Microsoft Word.
- Strongly preferred experience with PowerPoint and Excel.
- A degree in Accounting.
- Knowledge of CMS program regulations and cost report format.
- MBA, CPA, or CIA.
Responsibilities
- Work with audit leaders to identify skill gaps and prioritize training topics.
- Create course content and exercises with examples and guidance relevant to current audit practice.
- Facilitate training sessions, using audit experience to demonstrate processes and procedures.
- Plan, direct, and control specific provider audits.
- Serve as the in-charge auditor on large and/or complex field audits.
- Review and approve work performed by auditors on team audits.
- Participate in special projects and review work done by lower-level auditors as assigned.
- Analyze and interpret data and make recommendations for change based on judgment and experience.
- Maintain continuing education requirements.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase.
- 401(k) contribution.
- 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.
- 401(k) matching.
- Stock purchase plan.
- Life insurance.
- Wellness programs.
- Financial education resources.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
