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.

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 

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