Revenue Analytics & Reimbursement Specialist

Nwregionalheart; Glendale (CA); On-site; Full time

Job description

Job Description

Adventist Health Glendale is looking for Revenue Reimbursement Coordinator for Full-time, Day Shift. We are looking for great individual who can work onsite to our location in Glendale, CA

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary

Supports the Revenue Management department by performing account-level reviews, validating payer adjudication against contract terms, and preparing analytic reports to identify systemic issues, trends, and payer behaviors. Collaborates with Patient Access, Utilization Management, Case Management, Patient Financial Services, Revenue Integrity, and other Revenue Cycle pillars to support denial prevention, process improvement, payer escalations, and reimbursement optimization. Provides detailed account and trend analysis to assist the Director, Revenue Analytics in decision-making.

Education and Work Experience

• Associate’s/Technical Degree or equivalent combination of education/related experience: Required
• Bachelor's Degree: Preferred
• Five years' hospital/medical office experience: Preferred

Essential Functions

• Performs account-level reviews to ensure timely and full reimbursement according to payer contracts.
• Validates insurance coverage, contract assignment, and authorization status for high-dollar and at-risk accounts. Identifies barriers to clean claims and timely payment; tracks and trends denials, escalating systemic issues to the Director.
• Supports AR Reserve analysis and identifies trends that significantly impact net patient revenues. Prepares supporting reports and documentation for payer escalations, appeals, and Joint Operating Committees.
• Collaborates with Clinical and Revenue Cycle leaders to correct process gaps and prevent recurring revenue leakage.
• Maintains a cooperative and flexible team role, assisting the department with payer escalations and revenue cycle projects as needed.
• Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Pay and Benefits

The estimated base pay for this position is $39.16 to $53.71. Additional individual compensation may be available for this role through differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information.