Senior Reimbursement & Financial Analyst

Palomar Health

About The Position

Responsible for the evaluation and analysis of the financial condition of Palomar Health programs and facilities. Develops financial feasibility studies of proposed new programs and evaluations of existing programs, supports the strategic planning process, and assists in the development and monitoring of multi-year financial plans and service lines. Supports the preparation of the capital and operating budgets for Palomar Health acute and skilled nursing facilities and tracks progress in achieving the organization's financial goals and objectives, specifically with regard to long range financial plans and annual operating budgets. Collaborates with clinical and operational leadership to investigate monthly actual variances to budget and often recommends changes to operating procedures and processes to align with budgeted goals. Supports the development and tracking of revenue and cost initiatives. Develops ad-hoc reports as requested utilizing the organization's ERP, decision support, and financial systems and tools. Responsible for preparation of quarterly OSHPD reports, annual OSHPD reports, ALIRTS, AHA Annual Survey and Occupational Mix Survey. Assist the Director of Finance, Special Projects in preparing annual Medicare and Medi-Cal Cost Reports for submission to CMS and DCHS. as well as various cost report appeals and re-openings. Perform cost report data gathering to be used in cost report preparation. Perform reasonableness testing for all data gathered to determine propriety of data received. Assist in Medi-Cal and Medicare audits as well asother reimbursement related projects as assigned. Responsible for PS&R crosswalk and data request from CMS. Responsible for Paid Claims Report request and analysis. Reconciles third-party due to and due from accounts. Perform complex analysis and comparisons. Work closely with staff from Revenue Cycle, Managed Care Contracting and HIM. Be trained to run financial reports from ERP and cost accounting systems, as well as and other software programs as necessary. Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment). personal computer, computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, Outlook, Smartsheet, etc.). Knowledge of financial systems, included Workday, Axiom/Syntellis, and Lawson Infor, is preferred. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

Requirements

Bachelor's Degree in Accounting, Finance, or Business-related field
2 - 4 years of progressive experience in reimbursement, financial accounting, or financial analysis
Advanced working knowledge of Excel and Access and ability to perform manipulations of large amounts of data
Knowledge of standard office equipment). personal computer, computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, Outlook, Smartsheet, etc.).

Nice To Haves

Previous experience with fiscal intermediaries or a CPA firm
Experience in a multi-hospital setting
Certified Public Accountant (CPA)
Knowledge of financial systems, included Workday, Axiom/Syntellis, and Lawson Infor, is preferred.

Responsibilities

Evaluation and analysis of the financial condition of Palomar Health programs and facilities.
Develops financial feasibility studies of proposed new programs and evaluations of existing programs
Supports the strategic planning process
Assists in the development and monitoring of multi-year financial plans and service lines.
Supports the preparation of the capital and operating budgets for Palomar Health acute and skilled nursing facilities
Tracks progress in achieving the organization's financial goals and objectives, specifically with regard to long range financial plans and annual operating budgets.
Collaborates with clinical and operational leadership to investigate monthly actual variances to budget and often recommends changes to operating procedures and processes to align with budgeted goals.
Supports the development and tracking of revenue and cost initiatives.
Develops ad-hoc reports as requested utilizing the organization's ERP, decision support, and financial systems and tools.
Responsible for preparation of quarterly OSHPD reports, annual OSHPD reports, ALIRTS, AHA Annual Survey and Occupational Mix Survey.
Assist the Director of Finance, Special Projects in preparing annual Medicare and Medi-Cal Cost Reports for submission to CMS and DCHS. as well as various cost report appeals and re-openings.
Perform cost report data gathering to be used in cost report preparation.
Perform reasonableness testing for all data gathered to determine propriety of data received.
Assist in Medi-Cal and Medicare audits as well asother reimbursement related projects as assigned.
Responsible for PS&R crosswalk and data request from CMS.
Responsible for Paid Claims Report request and analysis.
Reconciles third-party due to and due from accounts.
Perform complex analysis and comparisons.
Work closely with staff from Revenue Cycle, Managed Care Contracting and HIM.
Be trained to run financial reports from ERP and cost accounting systems, as well as and other software programs as necessary.
Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position.
Performs other duties as assigned.
Follows Palomar Health rules, policies, procedures, applicable laws and standards.
Carries out the mission, vision, and quality commitment of Palomar Health.