Reimbursement Senior Analyst

Intermountain Healthcare Inc.; Oregon; Hybrid; USD 47,000 - 74,000; Full time

Job summary

Intermountain Health is seeking a reimbursement specialist to analyze third-party financial accounting, cost reports and settlements across multiple hospitals. You will collaborate with Finance, Revenue Cycle and Operations to optimize reimbursements and ensure compliance with federal and state regulations.

The role requires strong knowledge of Medicare/Medicaid reimbursement methodologies, cost reporting and data analytics.

Qualifications

• Bachelor’s degree in accounting, finance or related field with four years’ experience; degree verified.
• Master’s degree in accounting, finance, or related field with two years experience; degree verified.
• Computer skills with spreadsheets, databases, word processing and Internet.

Responsibilities

• Performs routine and non-routine tasks with in-depth analysis, identifying alternatives and proposing plans.
• Manages reimbursement processes and explores variances; collaborates with HIM, PAS, and hospital finance staff.
• Prepares Medicare/Medicaid settlement and policy reserve calculations using compliant methodologies.
• Prepares cost reports and surveys, reviews audit adjustments, and files appeals to maximize reimbursement.
• Mentor and coordinate reimbursement team members when needed.
• Stay current on reimbursement laws and assess impact on operations with minimal supervision.
• Manage scope, deadlines, and deliverables; develop and revise system procedures and standards.
• Investigate changes in reimbursement and communicate impacts to leadership.
• Responsible for 2+ hospitals or 1+ hospital plus Central Office assignments.

Skills

Reconciliation

Accounting

Accounts Payable/Receivable Process

Medicare

Medicaid

General Ledger

Financial Statements

Analytical Thinking

Reimbursement

Education

Bachelor's degree in accounting, Finance or other business related field

Master's degree in accounting, Finance, or other business-related field

Tools

Computer skills (spreadsheets, databases, word processing, Internet)

Job description

Job Description: Prepares or reviews third-party financial accounting, contractual allowances, cost reports and surveys, and other projects as assigned. Requires no supervisor assistance for routine tasks and minimal supervision for non-routine tasks. We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Washington. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings. The hiring manager is considering applicants who have experience in Medicare and Medicaid reimbursement methodologies, hospital cost reporting, financial modeling, data analytics, audit processes, and reimbursement settlements. Proven ability to interpret and apply complex federal and state healthcare regulations. We seek candidates who bring diverse professional backgrounds, experiences, perspectives, and innovative problem-solving skills, with the ability to collaborate effectively across Finance, Revenue Cycle, Operations, Government Relations, and Executive Leadership to support organizational goals and drive strategic outcomes. Schedule - Standard business hours, Monday through Friday. Position may require occasional additional hours during peak regulatory filing periods, audits, settlements, budget season, or other critical reimbursement deadlines.

Essential Functions

• Performs routine and non-routine tasks requiring more in-depth analysis and is expected to identify alternatives and recommend plans to resolve problems. Direction is limited to overall process and complex problems. Timely and accurately completes assigned tasks.
• Performs or reviews reimbursement processes (i.e., reconciliation of third-party G/L accounts, calculation of actual and budgeted contractual allowances and variances, monitoring of individual claims (logs), etc.). Interacts with HIM, PAS, and hospital finance staff as needed.
• Prepares monthly Medicare and Medicaid settlement and policy reserve calculations using technically acceptable and reasonably conservative reimbursement methodologies.
• Prepares or reviews cost reports and surveys, reviews audit adjustments and settlements, and files appeals and exception requests to appropriately maximize reimbursement. Interacts with Medicare Administrative Contractor, State Medicaid, and hospital personnel as needed.
• Acts as a mentor. May be responsible for the coordination, training, direction and review of those working with reimbursement functions.
• Understands and stays current on laws and regulations related to reimbursement. Determines the impact of reimbursement changes on hospital operations with minimal supervision.
• Responsible for managing scope and completion of work, meeting deadlines, and providing deliverables to the customers or end users. Manages complex projects, schedules and facilitates meetings as necessary to complete assignments. Develop, document and revise system design procedures, test procedures and quality standards.
• Investigations changes in reimbursement and communicates potential impacts to reimbursement. Communicates effectively with site and system financial leadership to establish key financial variables requiring special analysis.
• Is responsible for 2+ hospitals or 1+ hospital and Central Office assignments.

Skills

• Reconciliation
• Accounting
• Accounts Payable/Receivable Process
• Medicare
• Medicaid
• General Ledger
• Financial Statements
• Analytical Thinking
• Reimbursement

Qualifications Required

• Bachelor's degree in accounting, Finance or other business related field with four years‘ experience. A degree must be obtained from an accredited institution. Education is verified.
• Master's degree in accounting, Finance, or other business-related field with two years experience. Education must be obtained from an accredited institution. Degree will be verified.
• Computer skills including spreadsheets, databases, word processing, and Internet.

Preferred Qualifications

• Bachelor's degree in accounting, Finance or other business related field with four years‘ experience. A degree must be obtained from an accredited institution. Education is verified.
• Master's degree in accounting, Finance, or other business-related field with two years experience. Education must be obtained from an accredited institution. Degree will be verified.
• Computer skills including spreadsheets, databases, word processing, and Internet.

Physical Requirements

• Ongoing need for employee to see and read information, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
• May have the same physical requirements as those of clinical or patient care jobs, when the leader takes clinical shifts.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location: Peaks Regional OfficeWork City: BroomfieldWork State: ColoradoScheduled Weekly Hours: 40The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $34.26 - $53.96

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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