Reimbursement Analyst - Hybrid - 139367

Reimbursement Analyst - Hybrid

The Reimbursement Analyst provides support and analysis of government reimbursement for the hospital, this includes Medicare, Medi-Cal, and HCAI, etc. The Reimbursement Analyst prepares monthly Accounts Receivable Valuation and Net Revenue Impacts. This role ensures timely and accurate financial and governmental reporting such as Annual Medicare Cost Reports, Annual and Quarterly HCAI reports. Prepares audit responses for all relevant external and internal audit reviews, including those conducted by Medicare, Medi-Cal, HCAI, OIG, and other agencies, as well as the health system's annual financial audit. The Analyst is responsible for monitoring of state and federal regulatory proposals related to healthcare payment policies with the ability to perform impact assessments.

This position will work a hybrid schedule which includes a combination of working both onsite at Greenwich Drive (San Diego, CA) and remote.

Minimum Qualifications

• Nine (9) years of related experience, education/training OR a Bachelor's degree in related area plus five (5) years of related experience/training. Related experience includes: Medicare, Medi-Cal, HCAI, OSHPD, P14, Medi-Cal Waiver cost report preparation or audit. Accounts Receivable Valuation and performing complex financial analysis. Hospital finance and budgets.
• Maintains advanced knowledge in healthcare reimbursement revenue cycle workflow, financial reporting concepts and industry best practices. Proven ability to apply knowledge and skills to identify improvements.
• Comprehensive knowledge of relevant department, medical center, and UC policies and processes. In-depth knowledge of relevant Medicare, Medi-Cal, and third party payer regulations. Ability to apply policy knowledge to proactively identify potential risk areas.
• Advanced skills in data management and analysis.
• Project management skills to lead a team, prioritize personal and team tasks and see projects through from inception to completion on schedule. Demonstrates adaptability and flexibility to effectively handle change.
• Advanced knowledge of financial analysis, research, and reporting, particularly as it applies to reimbursement in healthcare settings.
• Advanced interpersonal skills, with the ability to collaborate effectively on highly-complex projects in a team environment with a wide variety of business and clinical areas.
• Advanced communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations to all levels of staff and management.
• Ability to perform all commonly applicable functions in word processing and spreadsheet software. Advanced knowledge of organization's Reimbursement Healthcare application programs to troubleshoot issues and recommend improvements in convenience and efficiency.

Preferred Qualifications

• Experience working within a Health Insurance Company.
• Experience working within a Medicare Intermediary.
• Performed Impact Analysis of government regulations.
• History with academic medical center, organ transplant hospital, Medicare Intermediary, Healthcare Consulting.
• Experience demonstrating process improvement.

Special Conditions

• Must be able to work various hours and locations based on business needs.
• Employment is subject to a criminal background check and pre-employment physical.