Reimbursement Analyst I

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 nations largest nonprofit Catholic healthcare organizations CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2300 clinics care sites and 137 hospital-based locations in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157000 employees 45000 nurses and 25000 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.

Job Summary / Purpose
The 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 Reimbursement Analyst interacts with customers and ensures value is delivered and customer satisfaction is achieved. The Reimbursement Analyst also assists in the improvement of internal business processes and meeting future reimbursement service needs.

The 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 Healths Mission Philosophy and core values of Collaboration Dignity Excellence Justice and Stewardship. The Reimbursement Analyst reports to the Reimbursement Managers and/or Directors.

Essential Functions

• 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

Education and Experience:

• Bachelors Degree in Accounting Finance Business Administration or related field.
• Minimum of one years of experience with all aspects of Medicare and Medicaid (Medi-Cal) regulations monitoring and report processes
• Experience as hospital Reimbursement staff or auditing experiences with Fiscal Intermediary
• Minimum of one 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
• Experience and knowledge of current reimbursement regulations and applications in a complex healthcare environment