Responsibilities
Position Summary:
The Senior Reimbursement Analyst is responsible for providing cost report preparation cost report appeals audit preparation and other duties related to the regulatory reimbursement services of Dignity Health. The position maintains current knowledge of Medicare Medicaid and other State and Federal regulations. The Sr. Reimbursement Analyst interacts with customers and ensures value is delivered and customer satisfaction is achieved. The Sr. Reimbursement Analyst also assists in the improvement of internal business processes and meeting future reimbursement service needs.
The Senior Reimbursement Analyst carries out his/her duties by adhering to the highest standards of ethical and moral conduct acts in the best interest of Dignity Health and fully supports Dignity Health's Mission Philosophy and core values of Collaboration Dignity Excellence Justice and Stewardship. The Senior Reimbursement Analyst reports to the Reimbursement Managers and/or Directors.
Accountabilities:
Prepares interim and annual cost reports for Medicare Medicaid and other State or Federal agencies for Dignity Health facilities and regions
Calculates periodic adjustments for deductions from revenue revenue reserves bad debt and other revenue adjustments related to regulatory reimbursement for all Dignity Health facilities and regions in accordance with Dignity Health policies and procedures
Assist the Reimbursement Managers and/or Directors with recommendations for internal Dignity Health strategy by evaluating current growth anticipating future needs and assessing impact of services delivered
Assists in the maintenance of standardized policies and procedures and third party settlement methodologies
Reviews operational reports identifies opportunities/problems and makes recommendations for improving processes
Assesses the impact of new products technology and processes on the existing organization and makes recommendations for improvement
Required Non-Technical Competencies:
Commitment to Dignity Health Values
Analytical Thinking
Continuous Improvement
Problem Solving
Customer Orientation
Team Orientation
Flexibility
Communication Ability
Reasoning
Required Technical Competencies:
Medicare
Medicare Regulatory Reporting
Medicaid (Medi-Cal)
Medicaid (Medi-Cal) Regulatory Reporting
Accounts Receivable and Cash Collection
Capital and Fixed Assets
Reimbursement - Monthly Analysis Process
Decision Support
General Accounting
Cost Reporting
Qualifications
Minimum Qualifications:
Minimum of five (5) years of experience with all aspects of Medicare and Medicaid (Medi-Cal) regulations monitoring and report processes required
Experience as hospital Reimbursement staff or auditing experiences with Fiscal Intermediary required
Minimum of five (5) years of experience and excellent working knowledge of general accounting government reimbursement appeals and audits in a complex organization and maintaining relationships with internal and external entities such as general accounting patient accounting and fiscal intermediaries required
Experience and knowledge of current reimbursement regulations and applications in a complex healthcare environment required
Bachelor's degree in Business Administration Accounting or equivalent work experience required
Required at times but very limited
Overview
Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.
Pay Range
$36.96 - $53.60 /hour
We are an equal opportunity employer.