Summary
 

Why should you join the BlueCross BlueShield of South Carolina family of companies?

Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose:

Responsible for supervising the receipt, review, and settlement of the Medicare cost report, ensuring all Centers for Medicare and Medicaid Services (CMS) requirements are met throughout the process.

Description
 

Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies.

Location: This position is full-time (40-hours/week) Monday-Friday working ONSITE at our Birmingham, AL location or REMOTE in the U.S. You will work an 8-hour shift scheduled during our business hours of 8:00AM-5:00PM.  

What You’ll Do:

• Performs supervisory review of all audit work papers completed by the team to ensure all work conforms to CMS and other government auditing standards.

• Performs supervisory review of all cost report acceptances and desk reviews to ensure timeliness requirements are met and all CMS standards are adhered to.

• Plans, monitors, and budgets all work assigned for the team, and evaluates and reports results.

• Performs supervisory review of all settlement packages ensuring product meets all CMS standards.

• Assists in developing the audit staff by providing on-the-job training as well as preparing and presenting formal staff training sessions.

• Researches issues and responds to provider and CMS requests in a timely manner.

 

To Qualify for This Position, You'll Need the Following:

• Required Education: Bachelor’s degree in a job related field

• Required Work Experience: 5 years auditing or accounting experience including 1 year in a leadership role or equivalent military experience in grade E4 or above

• Required Software and tools: Microsoft Office

• Required Skills and Abilities:

  • Knowledge of cost accounting standards and Generally Accepted Accounting Principles.

  • Knowledge and use of auditing standards and statistical sampling techniques.

  • Good planning, organization, and human relations skills.

  • Knowledge of the principles and practices of auditing.

  • Ability to analyze and determine the applicability of financial data.

  • Ability to gather information by examining records and documents and to interview individuals.

  • Strong interpersonal skills.

  • 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.

  • Ability to handle sensitive matters on a confidential basis.

  • Ability to make presentations and apply critical thinking skills.

  • Knowledge of provider reimbursement review board.

  • Ability to interpret and implement changes to Medicare program.

  • Thorough understanding of Uniform Cont