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The Reimbursement Analyst III is responsible for preparing, reviewing, and analyzing complex regulatory reports and cost filings required by Medicare, Medicaid/Medi‑Cal, and other federal and state agencies. This role supports the organization’s largest and most complex affiliates and requires demonstrated, hands‑on experience with HCAI (formerly OSHPD) reporting and Medicare cost report preparation.
Job Responsibility:
Preparing, analyzing, and validating cost reports, supplemental filings, and regulatory disclosures in accordance with CMS, Medicare, Medicaid/Medi‑Cal, and state agency requirements
Performing detailed review of Medicare and Medicaid/Medi‑Cal audit adjustments
managing the appeals process including preparation of supporting documentation and coordination with CMS/HCFA, HCAI, and the Department of Health Services
Serving as a subject matter expert on HCAI annual reporting, Medicare/Medicaid reimbursement methodologies, program regulations, and cost report implications
Providing financial impact analyses on regulatory changes, newly enacted or proposed legislation, and reimbursement updates
producing multi‑year projections for system and affiliate leaders
Supporting managed care negotiations by supplying reimbursement modeling, trending analyses, and regulatory insights that influence payer strategy
Collaborating with affiliate finance teams during contractual reviews and audits, and with external auditors or third‑party consultants on reimbursement‑related evaluations
Contributing to annual budget development and forecast cycles by supplying government‑payer revenue projections grounded in cost report and HCAI data
Ensuring accuracy, timeliness, and compliance across all submissions, internal workpapers, and supporting documentation
Requirements:
Direct, recent experience preparing and filing HCAI (OSHPD) reports for large or multi‑facility healthcare organizations
Demonstrated experience preparing Medicare cost reports (e.g., Form CMS‑2552‑10) including worksheets, supporting schedules, audit follow‑up, and appeals
Strong knowledge of CMS reimbursement principles, Medi‑Cal reimbursement methodologies, and regulatory reporting standards
Advanced analytical skills with the ability to interpret complex regulatory guidance and translate it into financial impact models
What we offer:
Competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage with plans that can fit each employee’s needs
401k plan that includes a company match and is fully vested after you become eligible
Paid time off, sick time, and paid company holidays
Employee Assistance Program (EAP) that provides services like virtual counseling, financial services, legal services, life coaching