Talent.com
Audit & Reimbursement III (US)
Audit & Reimbursement III (US)NY Staffing • Providence, RI, US
Audit & Reimbursement III (US)

Audit & Reimbursement III (US)

NY Staffing • Providence, RI, 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.

    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.

    [job_alerts.create_a_job]

    Audit Reimbursement • Providence, RI, US

    [internal_linking.related_jobs]
    Travel Nurse - RN - ICU - Intensive Care Unit - $2014 / Week - Hiring Now

    Travel Nurse - RN - ICU - Intensive Care Unit - $2014 / Week - Hiring Now

    LRS Healthcare - Nursing • Newport, RI, US
    [job_card.full_time]
    LRS Healthcare - Nursing is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Newport, RI. Shift : Inquire Start Date : 12 / 22 / 2025 Duration : 13 weeks Pa...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Internal Medicine Opportunity in Vermont

    Internal Medicine Opportunity in Vermont

    AMN Healthcare • Newport, US
    [job_card.full_time]
    Job Description & Requirements.Internal Medicine Opportunity in Vermont.StartDate : ASAP Pay Rate : $270000.A highly respected community hospital nestled in scenic Vermont is seeking a dedicated ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Project Manager - Oncology / Hematology (Phase III)

    Senior Project Manager - Oncology / Hematology (Phase III)

    Syneos Health / inVentiv Health Commercial LLC • Providence, RI, United States
    [job_card.full_time]
    Senior Project Manager - Oncology / Hematology (Phase III).Syneos Health is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success.We translate uniqu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Prior Authorization Pharmacy Tech I

    Prior Authorization Pharmacy Tech I

    ICONMA • RI, US
    [job_card.full_time]
    Our Client, a Retail Pharmacy company, is looking for a Prior Authorization Pharmacy Tech I for their Remote location.The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members,...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    OB / GYN Locum Tenens

    OB / GYN Locum Tenens

    HealthEcareers - Client • Newport, RI, USA
    [job_card.part_time] +1
    Newport Hospital – Newport, Rhode Island.OB / GYN Full Scope – Locum Tenens (with option to extend or transition to a permanent role). OBstat provides full-scope OB / GYN care, including : .Providing bo...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Payer Enrollment Coordinator

    Payer Enrollment Coordinator

    Rose International • Cumberland, RI, US
    [job_card.full_time] +1
    Estimated Duration (In months) : .Compliance, Medicaid, Medicare.High School Diploma or equivalent.High School Diploma or GED Required. Bachelors Degree in Business Administration, Marketing, Finance ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Medical Consultant- Remote

    Medical Consultant- Remote

    Unum • Providence, RI, United States
    [filters.remote]
    [job_card.full_time]
    When you join the team at Unum, you become part of an organization committed to helping you thrive.Here, we work to provide the employee benefits and service solutions that enable employees at our ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Regional Director - Finance

    Regional Director - Finance

    Bally's Corporation • Lincoln, RI, United States
    [job_card.full_time]
    Bally's Corporation (NYSE : BALY) is a global casino-entertainment company with a growing omni-channel presence.Bally's owns and operates 19 casinos across 11 states, along with a golf course in New...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Infectious Disease Consulting

    Infectious Disease Consulting

    ID Partners • Mansfield, US
    [job_card.full_time] +1
    Well established, leading ID practice in DFW metro area! Seeking to hire full time Infectious Disease consulting.Part-time tract with flexible hours also available. Mostly inpatient ID consulting, w...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Insurance Claims Environmental

    Insurance Claims Environmental

    Diedre Moire Corp. • Newport, RI, US
    [job_card.full_time]
    Claims Examiner Environmental - Newport, RI Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard _. REMOTE WORK FROM HOME AVAILABL...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Assistant Casino Regulatory Manager, Plainville

    Assistant Casino Regulatory Manager, Plainville

    Mass., Inc. • Plainville, MA, United States
    [job_card.full_time]
    The Massachusetts Gaming Commission (MGC) seeks to hire an Assistant Casino Regulatory Manager (ACRM) assigned to the Plainridge Park Casino in Plainville, MA. With guidance from the Casino Regulato...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Sr Director Rebate Invoice and Audit - Synergie Medication Collective

    Sr Director Rebate Invoice and Audit - Synergie Medication Collective

    Blue Cross Blue Shield Association • Providence, RI, United States
    [job_card.full_time]
    The hiring range for this role is : .This is the lowest to highest salary we.A candidate's position within the.Note : No amount of pay is considered to be wages or compensation until such amount is ea...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    PT - Outpatient

    PT - Outpatient

    Bay State Physical Therapy • Walpole, MA, United States
    [job_card.full_time]
    Bay State Physical Therapy - Walpole, MA.Prime HealthCare Staffing, a national health care staffing company with over 20 years in the business, is looking for an experienced PT for a travel contrac...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Data Annotation • Pawtucket, Rhode Island
    [filters.remote]
    [job_card.full_time] +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel MRI Tech - $2,620 to $2,928 per week in Newport, RI

    Travel MRI Tech - $2,620 to $2,928 per week in Newport, RI

    AlliedTravelCareers • Newport, RI, US
    [job_card.full_time]
    AlliedTravelCareers is working with Prime Time Healthcare to find a qualified MRI Tech in Newport, Rhode Island, 02840!.Now Hiring : Allied Healthcare MRI - Newport, RI. Contact us for Pay Informatio...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Provost

    Provost

    InsideHigherEd • Newport, Rhode Island, United States
    [job_card.full_time]
    Naval War College invites applications and nominations of qualified candidates for the position of Provost to commence the appointment no later than 27 July 2026. The Naval War College (NWC) is firs...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Remote Utility Management Nurses (Insurance Coding & Revenue Management) - AI Trainer ($45-$75 per hour)

    Remote Utility Management Nurses (Insurance Coding & Revenue Management) - AI Trainer ($45-$75 per hour)

    Mercor • Pawtucket, Rhode Island, US
    [filters.remote]
    [job_card.part_time]
    Role Overview • • We’re seeking experienced • •Utility Management Nurses • • to support a client’s healthcare product development by leveraging expertise in • •insurance coding and hospital revenue manag...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Assistant Casino Regulatory Manager, Plainville

    Assistant Casino Regulatory Manager, Plainville

    State of Massachusetts • Plainville, MA, United States
    [job_card.full_time]
    The Massachusetts Gaming Commission (MGC) seeks to hire an Assistant Casino Regulatory Manager (ACRM) assigned to the Plainridge Park Casino in Plainville, MA. With guidance from the Casino Regulato...[show_more]
    [last_updated.last_updated_30] • [promoted]