Anthem, Inc. Compliance Audit Specialist in Clearwater, Florida
SHIFT: Day Job
Your Talent. Our Vision. At America’s First Choice, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.
Location: The selected candidate must reside in the state of Florida
Compliance Audit Specialist Responsible for ensuring program integrity by establishing an audit process that is efficient and effective in monitoring operations, and compliance with Federal, State laws and regulations, CMS, OIG, as well as contractual obligations.
Primary duties may include, but are not limited to:
Performs audits of external entities ensuring the fundamental systems of internal controls are in place and functioning; Claims, Call Center Operations, Network Management and Compliance Program Integrity ensuring adherence to contractual, regulatory, statutory and company standards
Assist management in identification and analysis of relevant risks to achieving predetermined business objectives.
Prepares appropriate written audit findings and recommendations for approval by the management team.
Assists in the preparation of materials for major compliance initiatives including external audits, site reviews, accreditations and required submissions to regulatory or oversight bodies
Completes Special Projects as assigned
Requires BA/BS degree, 2 years related experience; or any combination of education and experience, which would provide an equivalent background.
Analytical and Critical Thinking Skills
Excellent Verbal and Written Communication Skills
Audit or related Medicare Experience
Proficient in Microsoft Office, PowerPoint and Excel
Medicare Claims Processing Experience
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.