Audit & Reimbursement III - Training
About The Position
The Audit & Reimbursement III designs, delivers, and continuously improves audit training to help department staff develop the skills needed to complete limited or full desk reviews of hospital and non-hospital providers. The role works with audit leaders to identify skill gaps and prioritize training topics, creates course content and exercises aligned with current audit practices, and facilitates training 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; participates in special projects and reviews work completed by lower-level auditors as assigned; and analyzes and interprets data to recommend changes using judgment and experience. Associates are expected to maintain continuing education requirements. This role is primarily virtual, with required in-person training sessions. Applicants must be within a reasonable commuting distance of the posting locations unless granted a legally required accommodation. Foreign national applicants for the Wellpoint Federal division must have lived in the United States for at least three of the past five years. Government Business Division assignments may involve additional requirements, including more stringent background checks or clearances, role-specific training, monitoring, segregation of duties, and sensitive-data handling instructions.
Requirements
- A BA/BS degree and a minimum of 3 years of audit/reimbursement or related Medicare experience, or an equivalent combination of education and experience.
- For foreign national applicants to the Wellpoint Federal division: 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.
- Strong knowledge of PowerPoint and Excel.
- 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 practices.
- Facilitate training sessions and use audit experience to demonstrate processes and procedures.
- Plan, direct, and control specific provider audits.
- Serve as 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 performed by lower-level auditors as assigned.
- Analyze and interpret data and recommend changes 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, dental, and vision benefits.
- Short- and long-term disability benefits.
- 401(k) with match.
- 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
