Consultant - Reimbursement Analyst III

Job description:

Consultant – Reimbursement Analyst III

Schedule: Monday–Friday, 8:00 a.m. – 5:00 p.m.
Compensation: $50–$55 per hour
Work Arrangement: Remote or Hybrid (based on manager approval)

Overview

We’re seeking a skilled Reimbursement Analyst III (Consultant) to support systemwide reimbursement and cost reporting functions across multiple healthcare affiliates. This role provides key analytical and accounting support for hospital cost reports, regulatory filings, and financial performance tracking. The ideal candidate will ensure accuracy, compliance, and insight in reporting to Medicare, Medicaid/Medi-Cal, and other regulatory agencies, while contributing to strategic financial analysis and decision-making.

Key Responsibilities

Systemwide Reimbursement & Cost Reporting

• Prepare, analyze, and file accurate Medicare, Medicaid/Medi-Cal, and other regulatory cost reports.
• Ensure compliance with federal/state regulations and internal accounting policies.
• Develop comprehensive workpapers supporting reported revenues, expenses, and adjustments.
• Support cost report audits and appeals, validating findings and adjustments.

Financial Analysis & Compliance

• Perform detailed financial analyses and reconciliations to support hospital cost accounting and key financial metrics.
• Build and maintain reimbursement projections based on policy and regulatory changes.
• Review and validate contractual allowance calculations for third-party settlements and receivables.
• Ensure compliance with GAAP and reimbursement methodologies.

Cross-Functional Collaboration

• Partner with reimbursement, accounting, and finance teams across multiple entities.
• Collaborate with affiliate CFOs and leadership to finalize cost reports and review audit outcomes.
• Provide analytical support to internal stakeholders, including Managed Care and Financial Planning teams.
• Present complex financial data clearly to both technical and non-technical audiences.

Continuous Improvement & Team Support

• Offer technical guidance and training on reimbursement processes and reporting standards.
• Identify opportunities to improve reporting accuracy, efficiency, and compliance.
• Stay informed on evolving reimbursement requirements and audit standards.

Qualifications

• Bachelor’s degree in Accounting, Finance, Business, or Healthcare Administration (or equivalent experience).
• Minimum 5 years of recent experience in healthcare reimbursement, cost reporting, or financial analysis.
• Strong understanding of GAAP, Medicare/Medicaid reimbursement, and healthcare financial reporting.
• Advanced Excel skills (pivot tables, VLOOKUPs, reconciliations, complex formulas).
• Experience with Hospital Key Indicators (H&KI) or similar performance metrics.
• Excellent analytical, communication, and presentation skills.
• Working knowledge of OSHPD reporting and cost report audit/appeals processes.

Team & Reporting Structure

• Reports within the Accounting/Finance department under the Finance pillar.
• Works closely with a team of 9–10 reimbursement and financial professionals.
• Partners cross-functionally with system-level financial leaders and affiliate CFOs.

Job Types: Full-time, Contract

Education:

• Bachelor's (Required)

Experience:

• Recent Healthcare Reimbursement: 5 years (Required)
• Recent Cost Reporting, Financial Analysis: 5 years (Required)
• GAAP, Medicare/Medicaid Reimbursement: 4 years (Required)
• Excel, Pivot Tables, VLOOKUPS, reconiciliations: 4 years (Required)
• H&KI: 3 years (Required)