Accounting Reimbursement Analyst II

Ensign Services; California; On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Medical/Dental/Vision coverage

401(k) with company match

Onsite gym

Professional development

Sick/vacation plans

Job summary

Ensign Services, Inc. is offering an Accounting Reimbursement Analyst II focused on Medicare Cost Reporting at our San Juan Capistrano, CA center. The role supports Medicare/Medicaid cost reporting, analyzes data, and collaborates with the accounting team to ensure accurate reimbursements.

The ideal candidate has a strong accounting foundation, proficient Excel skills, and the ability to work independently within a team, with travel to TX required and a potential hybrid option after 90 days.

Qualifications

• Bachelor’s degree in Accounting or Finance (or equivalent).
• 2–3 years in accounting or reimbursement required.
• Proficiency with Outlook and Word; advanced Excel skills.
• Experience with large data sets; VLOOKUP/HLOOKUP/XLOOKUP and pivot tables.
• GAAP understanding; multi-state Medicare/Medicaid is a plus.
• Strong communication and ability to manage multiple projects.

Responsibilities

• Prepare Medicare/Medicaid cost reports across states with accuracy.
• Analyze reimbursement rates and state regulatory impacts.
• Review financial reports and communicate adjustments.
• Collaborate with auditors and regulatory agencies as needed.
• Reconcile Medicare/Medicaid settlements; manage related accounts.
• Stay updated on Medicare/Medicaid changes and rate impacts.

Skills

Advanced Excel

Data analysis

Attention to detail

Strong communication

Travel willingness

Education

Bachelor’s or Master in Accounting/Finance

Tools

Excel

SQL

Workday

OneStream

Job description

Accounting Reimbursement Analyst II (Medicare Cost Reporting)

Position Type:

Full Time, exempt employee.

Compensation:

$75,000 – $85,000 annually, DOE; may be eligible for bonus.

Location:

This position based onsite at our San Juan Capistrano, CA Service Center and may offer a hybrid work option after a 90-day probationary period (not fully remote).

About the Company:

Ensign Services, Inc. (“ESI”) is a subsidiary of The Ensign Group, Inc., which is a national leader in the operation of skilled nursing, senior living, rehabilitation, home health, hospice, and other healthcare services. ESI is known as the “Service Center” and provides the facilities and leaders it serves with “back-office” support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting.
We take our core values of Celebration , Accountability , Passion for Learning , Love One Another , Intelligent Risk Taking , Customer Second , and Ownership (“CAPLICO”) seriously. We want an individual in this role who will demonstrate these values through actions and words.

About the Opportunity:

The Accounting Reimbursement Analyst II plays an important role in supporting Medicare and Medicaid reimbursement analysis. This position works largely independently while staying connected to a collaborative team environment. In this role, you will prepare and complete Medicare and Medicaid cost reports, analyze financial and operational data, and support reimbursement-related functions within the accounting department. You will also develop expertise in Medicaid reporting for assigned states and help maintain financial models used for rate setting and special payment programs.
This role is ideal for someone with a strong accounting foundation, solid analytical skills, and the ability to work independently while contributing to team success. You will partner with a growing client base across the U.S. to deliver accurate, timely reimbursement analysis and reporting.

Job Duties and Responsibilities include, but are not limited to:

• Prepare Medicare and Medicaid cost reports across multiple states, ensuring accuracy and compliance with state and federal requirements.
• Analyze Medicaid reimbursement rates on a quarterly or annual basis, evaluating the financial impact of state regulations and proposed audit adjustments.
• Review payment and financial reports to identify, assess, and communicate cost report adjustments, including impacts to asset and liability accounts.
• Collaborate with state auditors and regulatory agencies, responding to inquiries and supporting audit processes.
• Analyze key balance sheet and income statement accounts, including accrued expenses and revenue accounts related to reimbursement.
• Reconcile receivable and payable accounts related to Medicare and Medicaid settlements, including bad debt.
• Stay current on changes to Medicare and Medicaid regulations, reimbursement methodologies, and rate impacts to ensure ongoing compliance and accuracy.
• Review monthly occupancy reports and support occupancy-related calculations used in reporting.
• Collaborate closely with service center accounting teams, including payroll, accounts payable, accounts receivable, tax, general ledger, and financial reporting, to support accurate and timely financial processes.
• Provide support for ad hoc projects and special initiatives as business needs arise.

Preferred Qualifications:

• Bachelor’s degree or Masters in Accounting or Finance (or equivalent experience), preferred.
• Minimum of 2-3 years of experience in accounting or reimbursement, required.
• Proficiency with standard office software, including Outlook and Word, with advanced Excel skills, including experience working with large data sets and proficiency with formulas such as VLOOKUP, HLOOKUP, and XLOOKUP, as well as nested IF/AND/OR statements and pivot tables.
• Multi-state Medicare and Medicaid reimbursement experience is a plus, but is not required.
• Experience with or exposure to data analytics strongly preferred, but not required.
• Ability to demonstrate a foundational understanding of cost reporting, is a plus, but not required.
• Understanding of GAAP accounting principles.
• Working knowledge of SQL is a plus, but not required.
• Experience with Workday is a plus, but not required.
• Experience with OneStream is a plus, but not required.
• Strong communication skills, with excellent attention to detail and the ability to prioritize and manage multiple projects.
• Eagerness to learn and grow, with a curiosity to build new skills and knowledge.
• Ability to travel to our Service Center in CA and our facilities in TX is required.

Physical Requirements:

Standard Office Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position, with or without reasonable accommodation.

More than 50% of the time:

• Sit, stand, and walk.
• Perform repetitive movements of the hands, arms, and legs.
• See, speak, and hear to effectively communicate with others and perform job duties.

Less than 50% of the time:

• Stoop, kneel, or crawl.
• Climb and balance.
• Carry and lift up to 20 pounds.

Ensign Services, Inc. complies with applicable federal, state, and local laws regarding reasonable accommodations for qualified individuals with disabilities.

Additional Information

Any offer of employment may be contingent upon the successful completion of job-related post-offer requirements, which may include background checks, reference checks, and/or other screenings or examinations as permitted by applicable law.

What We Offer

We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. Additionally, enjoy access to our fully equipped onsite gym (San Juan Capistrano office location). We also believe in supporting our employee’s professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com
Ensign Services, Inc. is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616.
Job ID 1789