What are the responsibilities and job description for the Financial Audit Analyst - eviCORE position at EviCore by Evernorth?
Position Summary
The Financial Audit Analyst will perform monthly, quarterly or ad hoc audits on Medicare reporting to ensure that the reporting is compliant with CMS protocols or technical specifications. The Financial Audit Analyst will report findings to internal business areas that require further action on the cases under review. The reporting reviewed is used by Clients for Medicare oversight, as well as Medicare Annual Reporting to CMS. The Financial Audit Analyst will assist with any questions that the Clients may have on the reporting. The Financial Audit Analyst will also assist with case presentation for CMS Medicare audits and client mock Medicare audits. The Financial Audit Analyst will also handle annual data validation audits for clients.
Essential Functions
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
The Financial Audit Analyst will perform monthly, quarterly or ad hoc audits on Medicare reporting to ensure that the reporting is compliant with CMS protocols or technical specifications. The Financial Audit Analyst will report findings to internal business areas that require further action on the cases under review. The reporting reviewed is used by Clients for Medicare oversight, as well as Medicare Annual Reporting to CMS. The Financial Audit Analyst will assist with any questions that the Clients may have on the reporting. The Financial Audit Analyst will also assist with case presentation for CMS Medicare audits and client mock Medicare audits. The Financial Audit Analyst will also handle annual data validation audits for clients.
Essential Functions
- Medicare reporting quality assurance.
- CMS and Mock audit support – case presentation.
- Annual Data Validation package compilation.
- Medicare Case file compilation.
- Bachelor’s degree with 3 years’ experience in a healthcare industry required.
- Knowledge of managed care/healthcare industry.
- Medicare Part C experience or clinical background.
- Experience successfully managing multiple deadlines.
- Strong, independent decision-making ability.
- Excellent written and oral communication skills.
- Ability to manage multiple projects to timely completion.
- Ability to professionally interface with others at all levels.
- Proven knowledge of Microsoft Word, Outlook, PowerPoint, and Excel. Knowledge of Smartsheet and Adobe (PDF) application is preferred.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
