Talent.com
Audit & Reimbursement III (US)
Audit & Reimbursement III (US)Missouri Staffing • Saint Louis, MO, US
Audit & Reimbursement III (US)

Audit & Reimbursement III (US)

Missouri Staffing • Saint Louis, MO, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Audit And Reimbursement III

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid / virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities.

How you will make an impact :

  • Analyzes and interprets data and makes recommendations for change based on judgment and experience.
  • Able to work independently on assignments and under minimal guidance from the manager.
  • Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements.
  • Gain experience with applicable Federal Laws, regulations, policies and audit procedures.
  • Respond timely and accurately to customer inquiries.
  • Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills.
  • Must be able to perform all duties of lower-level positions as directed by management.
  • Participates in special projects and review of work done by auditors as assigned.
  • Assist in mentoring less experienced associates as assigned.

Job specific functions for Reopening Team :

  • Review Medicare cost report re-openings initiated from provider requests, CMS requests, or by the MAC
  • Perform level 1 or level 2 audit review as part of the reopening process on all areas of the Medicare cost report such as Medicare DSH, Bad Debts, IME / DGME, NAH, Organ Acquisition and all cost based principles
  • Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records
  • Actively participate in development of Audit & Reimbursement standard operating procedures
  • Actively participate in workgroup initiatives to enhance quality, efficiency and training
  • Minimum Requirements :

  • Requires a BA / BS degree and a minimum of 3 years of audit / reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background.
  • This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years.
  • Preferred Skills, Capabilities and Experiences :

  • Degree in Accounting or Finance preferred.
  • Knowledge of CMS program regulations and cost report format preferred.
  • Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred.
  • MBA, CPA or CIA preferred.
  • Must obtain Continuing Education Training requirements (where required).
  • A valid driver's license and the ability to travel may be required.
  • 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.
  • For candidates working in person or virtually in the below location(s), the salary range for this specific position is $61,560 to $102,060 Locations : Maryland, Minnesota, Massachusetts, Nevada, New York, and Columbus, Ohio.

    In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

    Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

    [job_alerts.create_a_job]

    Audit Reimbursement • Saint Louis, MO, US

    [internal_linking.similar_jobs]
    Accounting

    Accounting

    Quality Talent Group • Alton, IL, US
    [job_card.full_time]
    Our client is a leading force in advancing safer, smarter AI technology.Their work has been featured in Forbes, The New York Times, and other major outlets for pioneering high-quality, human-verifi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Security Specialist III

    Security Specialist III

    ServiceSource, Inc. • Arnold, MO, United States
    [job_card.full_time]
    Make an impact by joining ServiceSource, a champion for people with disabilities.Explore new opportunities! ServiceSource is an organization of talented people who drive innovation, embrace change,...[show_more]
    [last_updated.last_updated_30] • [promoted]
    PATIENT DINING ASSOCIATE (DIETARY AIDE) (TEMPORARY)

    PATIENT DINING ASSOCIATE (DIETARY AIDE) (TEMPORARY)

    Morrison Healthcare • Alton, IL, US
    [job_card.full_time]
    We are hiring immediately for temporary.PATIENT DINING ASSOCIATE (DIETARY AIDE) .Alton Memorial - 1 Memorial Hospital, Alton, IL 62002. Note : online applications accepted only.Days and hours ma...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Physical Therapist Assistant - Rehabilitation

    Travel Physical Therapist Assistant - Rehabilitation

    Premier Medical Staffing Services • Alton, IL, US
    [job_card.permanent]
    Premier Medical Staffing Services is seeking a travel Physical Therapy Assistant for a travel job in Alton, Illinois.Job Description & Requirements. Premier Medical Staffing Job ID #591445.Pay p...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Field Reimbursement Manager

    Field Reimbursement Manager

    Syneos Health / inVentiv Health Commercial LLC • St. Louis, MO, United States
    [job_card.full_time]
    You are an expert facilitator : you open doors, foster communication, and bridge the gap.In this role, the Field Reimbursement Manager (FRM) will operate as the subject-matter expert on reimbursemen...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Manager, Provider Contracting (St. Louis, MO)

    Manager, Provider Contracting (St. Louis, MO)

    Medica • St. Louis, MO, United States
    [job_card.full_time]
    Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences an...[show_more]
    [last_updated.last_updated_30] • [promoted]
    CRNA and Lead CRNA openings in Southern IL

    CRNA and Lead CRNA openings in Southern IL

    GO Staffing • Dow, IL, US
    [job_card.full_time]
    Well respected Hospital in Southern IL has openings for a CRNA and a Lead CRNA about 1hr from St.OR is open M-F 630am-5p and up to 9hrs of call on Saturday and Sunday day hours only (8a-5p typicall...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Internal Medicine Physician

    Internal Medicine Physician

    GO Staffing • Jerseyville, Illinois, US
    [job_card.full_time]
    Internal Medicine physician employment in Illinois : .Seeking an Internal Medicine physician to join a well-respected healthcare system in Southwestern IL, about 50 mins from St.Call 1 : 7 or 1 : 8 (pho...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Physical Therapy Assistant - $1563.64 / Week

    Travel Physical Therapy Assistant - $1563.64 / Week

    Premier Medical Staffing Services, LLC • Alton, IL, US
    [job_card.full_time]
    Premier Medical Staffing Services, LLC is seeking an experienced Physical Therapy Assistant for an exciting Travel Allied job in Alton, IL. Shift : 5x8 hr days Start Date : 12 / 29 / 2025 Duration : 13 wee...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Relationship Manager III

    Relationship Manager III

    Cass Information Systems • St. Louis, MO, United States
    [job_card.full_time]
    The RM is responsible for building comprehensive financial relationships with existing and prospective clients by combining a thorough knowledge of the client's operations, condition, leadership, g...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Risk Adjustment Coding Compliance Analyst (Clinical)

    Senior Risk Adjustment Coding Compliance Analyst (Clinical)

    Centene • Saint Louis, MO, US
    [job_card.full_time] +1
    You could be the one who changes everything for our 28 million members.Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you&rsquo...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Manager Internal Audit

    Senior Manager Internal Audit

    Par Health • St Louis, MO, US
    [job_card.full_time]
    Reporting to the Head of Internal Audit and Internal Controls (IA / IC), this role will support in providing assurance to the Audit Committee in through developing and executing a risk-based annual a...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Audit & Reimbursement III- Medicare Cost Report Audit

    Audit & Reimbursement III- Medicare Cost Report Audit

    Missouri Staffing • Saint Louis, MO, US
    [job_card.full_time]
    Audit And Reimbursement III - Medicare Cost Report Audit.This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flex...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Medical Director - Medical Claims Review - Remote

    Medical Director - Medical Claims Review - Remote

    UnitedHealth Group • St. Louis, MO, United States
    [filters.remote]
    [job_card.full_time]
    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Clinical Documentation Integrity Specialist

    Clinical Documentation Integrity Specialist

    UnitedHealth Group • Fenton, MO, United States
    [job_card.full_time]
    Need to be onsite for meetings).Clinical Document Integrity Specialist.CDS) is responsible for day-to-day CDI implementation of processes related to the concurrent review of the clinical documentat...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel Outpatient Physical Therapist – Orthopedic Rehabilitation - $2,380 per week

    Travel Outpatient Physical Therapist – Orthopedic Rehabilitation - $2,380 per week

    Reliable Nurse Staffing • Arnold, MO, United States
    [job_card.full_time]
    Reliable Nurse Staffing is seeking a travel Outpatient Physical Therapist for a travel job in Arnold, Missouri.Job Description & Requirements. Reliable Nurse Staffing Job ID #57759902.Pay package is...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Rehabilitation Physical Therapist - $2,334 per week

    Travel Rehabilitation Physical Therapist - $2,334 per week

    Premier Medical Staffing Services • Arnold, MO, United States
    [job_card.permanent]
    Premier Medical Staffing Services is seeking a travel Rehabilitation Therapist for a travel job in Arnold, Missouri.Job Description & Requirements. Premier Medical Staffing Job ID #607954.Pay packag...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Part Time Registered Behavior Technician

    Part Time Registered Behavior Technician

    Aba Squad Inc • Barnhart, MO, US
    [job_card.full_time] +1
    Registered Behavior Technician (RBT) Barnhart.Opportunity to earn more over time with performance pay and bonuses.SignOn Bonus : $200 with training certificate. $500 if certified.Paid training, cert...[show_more]
    [last_updated.last_updated_30] • [promoted]