Reimbursement Analyst

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Prepares reimbursement analysis for contract negotiations and audits reimbursement for contract compliance. Assists in contract negotiations as well as maintaining contracting process.

Job Requirements:

Education and Work Experience:

• Associate's/Technical Degree or equivalent combination of education/related experience: Required

• Bachelor's Degree: Preferred

• Master's Degree in business administration: Preferred

• Three years' experience in managed care: Preferred

Essential Functions:

• Works with payers to resolve underpayments and other payment disputes. Audits patient accounts for compliance with contract terms.

• Assists in contract negotiations as needed. Acts as a liaison between organization personnel and payers. Models contract terms for negotiations.

• Performs necessary tasks in the daily work que to ensure that all underpayments and appeals are performed in a timely manner. Reports trends for improved cash flow.

• Participates in and coordinates the education and training of Patient Financial Services and Registration regarding insurance requirements.

• 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, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.