Salary: $30.84-$44.49 per hour

If hired for this position, you will be required to provide proof that you are fully vaccinated for COVID-19 prior to your start date, or have a valid religious or medical reason qualifying you for an exemption (that may or may not require accommodation) 

SUMMARY

Prepares reimbursement claims for health and/or mentalhealth care provided under Federal, State and Special medical aid programs or prepares yearly budget requests, annual financial plans and evaluates operational performance against expenditures standards.
Analyzes reimbursement requirements for Federal, State, and/or Special Programs to determine if claims for reimbursement conform to applicable rules and regulations and result in maximum revenue collection.

Prepares Medicare and Medi-Cal cost reports and State mandated disclosure reports.

Analyzes costs and develops rates for contractual agreements with County and Non-county providers.

Analyzes preliminary budget requests, conducts comparison studies of units and sub units previous financial performance and cost effectiveness, completes cost analysis, revenue forecast and reports findings and recommendations to financial management.

Develops and/or monitors annual financial plans/unit budget allocations for the expenditure of funds within each unit, monitors performance against the plans/allocations, analyzes and prepares summaries of financial activities to keep units and executive management informed of financial condition.

Develops, monitors and adjusts billing rates to reflect cost changes and maximize cost recovery.

Analyzes utilization of billing rates and/or contract allocations for appropriate application, informs management of problems and recommends corrective action.

Analyzes program performance data and conducts studies of accounts, records and the integrity of electronic data which are basic to program and financial reporting.

Identifies operational problems, develops solutions and recommends modifications in the automated accounting system to improve the responsiveness of the system to the needs of expenditure management.

Participates in cost, revenue, and accounting systems and procedural studies, reports findings and recommendations, implements those approved by Health Services or Mental Health, departmental administration and by the Auditor-Controller when necessary.

Writes policy and procedure manuals pertinent to accounting control, fiscal record keeping and audit trails.

Reviews, analyzes and drafts replies to audit findings of governmental agencies.

ESSENTIAL FUNCTIONS

Essential functions of this position include but are not limited to the following:

• Reconciles monthly capitation payments from health plans and compares to contract rates, prepares distribution reports to the facilities.
• Maintains and analyzes claims payment data, validates payments against claims submitted, and communicates with the health plans on capitation and claims payment issues.
• Performs analyses on revenue performance, monthly health plan membership and enrollment data, and prepares reports for program offices and other stakeholders.
• Assists in the coordination of a wide range of accounting functions for Health Services Administration (HSA), including encumbrances, payments, accruals, billings, expenditure distributions and journal transfers, ensuring the completeness and accuracy of transactions and accounting data.
• Processes transfers of revenues and reallocation of expenditures to other County departments.
• Prepares work papers, schedules, statistical summaries, and special reports as supporting documentation for State and County audits.
• Coordinate and oversee the submission of various journal vouchers, internal vouchers, and vouchers for proper cost, expenditure, and revenue distribution and allocation.

JOB QUALIFICATIONS

Positions allocable to this class conduct special studies, assignments or projects in expenditure management which involve the analysis of changes in laws, regulations or policies governing fiscal programs, the modification of accounting systems to incorporate changes and the production of program and financial reports. 

Education/Experience

Completion of accounting courses in an accredited college equivalent to 21 semester units or 32 quarter units including at least two courses in advanced accounting subjects such as governmental accounting, computerized accounting, or auditing -AND- One year of professional accounting or responsible staff experience in health care financial operations.

Certificates/Licenses/Clearances

• Successful clearing through the Live Scan process with the County of Los Angeles.

PHYSICAL DEMANDS

Stand: Frequently

Walk: Frequently

Sit: Frequently

Handling: Occasionally

Reach Outward: Occasionally

Reach Above Shoulder: Occasionally

Climb, Crawl, Kneel, Bend: Occasionally

Lift / Carry: Occasionally - Up to 50 lbs

Push/Pull: Occasionally - Up to 50 lbs

See: Constantly

Taste/ Smell: Not Applicable

Not Applicable = Not required for essential functions

Occasionally = (0 - 2 hrs/day)

Frequently = (2 - 5 hrs/day)

Constantly = (5 hrs/day)

WORK ENVIRONMENT

General Office Setting, Indoors Temperature Controlled

EEOC STATEMENT

It is the policy of Heluna Health to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law.