Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good – from the operating room to the boardroom, we are driven by our unique passion to live God’s love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.
We’re looking for someone to join our team as a Sr. Reimbursement Analyst who:
Develops and maintains systems for valuing Patient Accounts Receivable and Third-party settlements and explaining Net Revenue variances to budget and historical trends. Ensures that complete data is collected for the accurate and complete filing of government cost reports. Tracks and Manages adjustments by government auditors and ensures appeals are filed of any adjustments by auditors which are considered inappropriate.
Essential Functions:
- Reviews, analyzes and interprets executed insurance contracts, government regulations and other noncontracted business reimbursement methods. Sets up and maintains a Patient Account Receivable valuation system using historical payment averages with the use of logic and judgment to effectively represent most accurate result.
- Reviews, analyzes and interprets government regulations, applicable contract terms and cost accounting principles to set up and maintain monthly Settlement estimates which accurately calculate expected payments and contractual adjustments from all payers.
- Analyzes revenue and contractual adjustment variances against both budget and historical trend, by both payer and business segment to inform the markets about their operational performance results on a monthly basis. Present variances to management in standardized categorizes such as volume, payer mix, service mix, acuity mix, prior period adjustments and yield.
- Works with local markets, system shared services units and, as appropriate, with external consultants to collect and evaluate all information necessary for the accurate and complete preparation of both interim cost reports, and the filing of annual governmental cost reports.
- Works with all appropriate internal parties to defend filed cost reports to government auditors. Tracks and manages the settlements of Prior Year cost reports and any appropriate appeals of adjustments included by the auditors in their final Notice of Program Reimbursement reports.
- Performs other job-related duties as assigned.
Qualifications
You’ll be successful with the following qualifications:
Education:
- Bachelor’s Degree or equivalent combination of education/related experience: Required
Work Experience:
- Five years relevant experience: Preferred
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
The estimated base pay for this position is $77,402 – $116,104. Additional individual compensation may be available for this role through years of experience, 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.
Apply to learn more about our total compensation and benefits!