Accounting Reimbursement Analyst II

Ensign Services; Dallas (TX); Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical coverage

401(k) with company match

Life insurance

Sick/Vacation plans

Job summary

Ensign Services, Inc. is seeking an Accounting Reimbursement Analyst II to support Medicare and Medicaid reimbursement analysis from our Dallas service center. The role involves preparing cost reports, analyzing rates, and maintaining financial models for rate setting.

You will work independently within a collaborative team to ensure accurate reimbursement and reporting across states. This position requires strong accounting fundamentals, solid analytical skills, attention to detail, and the

Qualifications

• Bachelor’s degree or Masters in Accounting or Finance (or equivalent experience).
• Minimum of 2-3 years of experience in accounting or reimbursement.
• Advanced Excel skills with large data sets and lookup formulas.
• Strong GAAP understanding.
• SQL experience is a plus.

Responsibilities

• Prepare Medicare and Medicaid cost reports for multiple states.
• Analyze Medicaid reimbursement rates and regulatory impacts.
• Review financial reports and communicate cost report adjustments.
• Collaborate with state auditors and regulatory agencies.
• Reconcile accounts related to Medicare/Medicaid settlements.
• Stay current on Medicare/Medicaid regulation changes.
• Support occupancy-related calculations and reporting.
• Coordinate with service center accounting teams for timely processes.
• Provide ad hoc project support as needed.

Skills

Excel expertise

SQL basics

GAAP knowledge

Communication skills

Attention to detail

Education

Bachelor’s or Master’s in Accounting/Finance

Tools

Workday

OneStream

SQL

Job description

Position Type

Full Time, non-exempt employee.

Compensation

Commensurate with experience.

Location

This position based onsite at our Dallas, TX 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. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees.

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. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people.

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-date 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.

Additional Information

• Pre‑employment criminal background screening required.

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. 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.