Summary
 

Responsible for organizing the audit block into productive units or teams and directing the activities of the teams to meet the expectations of the department, the corporation, and the Centers for Medicare and Medicaid Service (CMS). Ensures workload production goals and standards are met and appropriate policies/work instructions are developed and communicated to staff.

Description
 

This is a full-time position working (40-hours/week) Monday-Friday. We are ideally considering candidates that can work on-site in Birmingham, AL or Columbia, SC but US-based remote candidates with strong credentials will be considered for the role.

What You’ll Do:

• Manages audit work to ensure appropriate flow of production is achieved within required timeliness standards. Reports results on a regular basis to management.

• Responds to provider questions on a wide range of audit topics and meets as necessary to resolve disputed items.

• Prepares instructions for staff to assist their understanding of Medicare regulations and company policies. Assists in the development of QMS instructions and programs and in the continued ISO certification of the unit.

• Communicates with and responds to inquiries from CMS and other government/external law enforcement agencies.

• Evaluates the composition of existing staff, interviews and hires new staff, completes annual performance evaluations, oversees promotional decisions, and shifts staff as needed to meet work requirements.

• Ensures audits are of sufficient quality and in compliance with all department, company, and CMS requirements through periodic review and inspection of work products. Responds to audit inquiries and findings produced by external reviewers.

• Performs special projects as assigned by management and expands working knowledge/technical skills.

To Qualify for This Position, You’ll Need:

• Bachelor's degree - Accounting, Finance, Business Administration, or other job-related field of study.

• 5 years experience in operational/functional audits within the healthcare industry.

• 2 years supervisory audit experience or equivalent military experience in grade E4 or above.

• Strong interpersonal skills and the ability to work professionally with persons at all levels.

• Ability to maintain effective working relationships.

• Ability to communicate clearly and effectively in oral and written form.

• Strong presentation, interviewing, and organizational skills with a strong attention to detail.

• Ability to make sound decisions.

• Strong knowledge of and proficiency in applying accounting principles and auditing standards.

• Strong knowledge of and proficiency in healthcare operational and financial systems.

• Ability to grasp and understand complex systems.

• Ability to analyze details and determine impact to corporation.

• Ability to understand management principles. Good planning, leadership, and human relations skills.

• Experience with Microsoft Office

Preferred Qualifications:

• Medicare Cost Report audit experience

Salary Range

Please note that this range represents the pay range for this and other positions that fall into this pay grade.  Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity. 

Range Minimum

$49,447.00

Range Midpoint

$72,092.00

Range Maximum

$94,737.00

What We can Do for You:

We offer our employees great benefits and rewards.  You will be eligible to participate in the benefits the first of the month following 28 days of employment.  

• Subsidized health plans, dental and vision coverage

• 401K retirement savings plan with company match

• Life Insurance

• Paid Time Off (PTO)

• On-site cafeterias and fitness centers in major locations

• Wellness program and healthy lifestyle premium discount

• Tuition assistance

• Service recognition

• Employee Assistance

• Discounts to movies, theaters, zoos, theme parks and more

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application.

Management will be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.

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