Ambulatory Reimbursement Analyst

Adventist Health • Roseville, CA

3d

About The Position

The Ambulatory Reimbursement Analyst prepares and analyzes monthly contractual adjustment journal entries for Adventist Health’s physician clinics. The role assists with the annual net revenue budget and explains monthly variances to budget and trends. It presents mathematical modeling and data analysis to management and other end users, and analyzes clinic net revenue variances by clinic and carrier type for monthly and annual budget analysis. The analyst uses multiple data sources, including SQL Server database pivot tables and Power BI dashboards, to review reimbursement and charging patterns across practice specialties. The role applies knowledge of clinic reimbursement methodologies and insurance requirements and payment methodologies to understand and explain revenue results. It also monitors billing system issues, helps resolve issues affecting general ledger assignments, applies collection rates when historical information is unavailable, prepares chargemaster pricing based on Medicare and commercial fee schedules, and models net revenue forecasts for clinic model changes. The analyst collaborates with a team to identify problems and improve processes, and performs other job-related duties as assigned.

The position is based in the Adventist Health corporate headquarters in Roseville, California. Adventist Health requires associates to receive required vaccinations as a condition of employment and annually thereafter where applicable; medical and religious exemptions may apply. Adventist Health participates in E-Verify.

Requirements

• Bachelor’s degree in accounting, finance, economics, business administration, or a related field.
• Advanced Excel knowledge, including pivot tables, LOOKUP, INDEX, MATCH, and GETPIVOT.
• Basic accounting knowledge, including creating journal entries from data and understanding debits and credits.

Nice To Haves

• Master’s degree in business administration.
• Three years of experience in healthcare reimbursement or revenue cycle.

Responsibilities

• Prepare and analyze monthly contractual adjustment journal entries for Adventist Health physician clinics.
• Assist in preparing the annual net revenue budget and provide explanations of monthly variances to budget and trends.
• Present mathematical modeling and data analysis results to management and other end users.
• Analyze and explain clinic net revenue variances by clinic and carrier type during monthly and annual budget analysis for market finance officers, finance staff, and physician enterprise executives.
• Use data sources, including pivot tables from SQL Server databases and Power BI dashboards, to analyze reimbursement and charging patterns across practice specialties.
• Apply knowledge of reimbursement methodologies for different clinic types and insurance requirements and payment methodologies to understand and explain net revenue variances.
• Monitor billing system issues and work with coding, registration staff, or others to resolve issues that affect general ledger assignments.
• Apply collection rates for clinics and payer categories when historical information is unavailable.
• Provide accurate chargemaster pricing for foundation clinics based on Medicare and commercial fee schedules by CPT code.
• Model net revenue forecasts for clinic model changes, such as a change from an independent clinic to a hospital-based clinic or rural health clinic.
• Work with a team to identify problems and participate in instituting an improvement process.
• Perform other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time