BlueCross BlueShield of South Carolina

Government Audit Manager

BlueCross BlueShield of South Carolina • $95K — $115K *
US-AnywhereRemote in United States
Education, Government & Non-Profit
5 - 7 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree in Accounting, Finance, Business Administration, or related field.
  • 5 years of operational/functional audit experience in healthcare.
  • 2 years of supervisory audit experience or military equivalent.
  • Strong interpersonal skills for professional interaction at all levels.
  • Proficient in accounting principles and auditing standards.

Responsibilities

  • Manage audit workflow to meet production timelines and report results to management.
  • Address provider inquiries regarding audits and resolve disputes as needed.
  • Prepare staff instructions related to Medicare regulations and company policies.
  • Communicate with CMS and external law enforcement regarding inquiries.
  • Evaluate staffing needs, conduct interviews, and manage performance evaluations.
  • Ensure audit quality and compliance through regular review of work products.
  • Assist with special projects and enhance technical knowledge.

Benefits

  • Subsidized health plans, dental and vision coverage.
  • 401K with company match.
  • Life insurance coverage.
  • Paid time off (PTO).
  • Access to on-site cafeterias and fitness centers.
  • Wellness program with premium discounts for healthy lifestyles.
  • Tuition assistance for further education.
  • Employee assistance programs for personal support.
  • Discounts for various entertainment options including movies and theme parks.
Full Job Description
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


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.

About BlueCross BlueShield of South Carolina

BlueCross BlueShield of South Carolina is a health insurance company that provides coverage to over 5 million people in South Carolina and beyond. The company was founded in 1946 and is headquartered in Columbia, South Carolina. BlueCross BlueShield of South Carolina offers a variety of health insurance plans, including individual and family plans, Medicare plans, and employer-sponsored plans. The company is committed to improving the health of its members and the communities it serves, with initiatives focused on wellness, disease prevention, and access to care. BlueCross BlueShield of South Carolina is a subsidiary of the Blue Cross Blue Shield Association, a national federation of 36 independent, community-based and locally operated Blue Cross Blue Shield companies.
Learn more about BlueCross BlueShield of South Carolina
Size
12,000 employees
Industry
Healthcare
* Ladders Estimates

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