Ambulatory Reimbursement Analyst

Education and Work Experience:

• Bachelors degree in accounting, finance, economics, business administration or related field: Required
• Master’s Degree in business administration: Preferred
• Three years' experience in healthcare reimbursement or revenue cycle: Preferred
• Advanced Excel knowledge (i.e. Pivot tables, LOOKUP, INDEX, MATCH, GETPIVOT): Required
• Basic accounting knowledge (creation of journal entries from data, understanding of debits and credits): Required

Essential Functions:

• Presents the results of mathematical modeling and data analysis to management or other end users. Analyzes and explains net revenue variances in the clinic setting down the clinic and carrier type monthly and annually during budget analysis for presentation to market finance officers and other finance staff, and physician enterprise executives.
• Understands and uses several data sources, including pivot tables from SQL server databases, as well as Power BI dashboards to analyze and understand different practice specialties’ reimbursements and charging patterns. Understands and applies knowledge of different reimbursement methodologies of different clinic types to understand and explain net revenue variances.
• Understands and applies knowledge of requirements and payment methodologies of different insurance types. Monitors billing system issues and works with coding, registration staff, or others to fix issues impacting general ledger assignment.
• Applies collection rates for clinics and payer categories where we do not have historical information available. Provides accurate chargemaster pricing for foundation clinics based on Medicare and commercial fee schedules by CPT code.
• Models net revenue forecasts for clinic model changes (i.e. independent clinic to hospital based or rural health clinic). Works in a team setting to identify problems and participates in instituting an improvement process.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.