Sr Reimbursement Analyst

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.

1. Prepares interim and annual cost reports for Medicare, Medicaid and other State or Federal agencies for Dignity Health facilities and regions
2. 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
3. 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
4. Assists in the maintenance of standardized policies and procedures and third party settlement methodologies
5. Reviews operational reports, identifies opportunities/problems, and makes recommendations for improving processes
6. Assesses the impact of new products, technology, and processes on the existing organization and makes recommendations for improvement

• 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