CrawlJobs Logo

Reimbursement Analyst III

medasource.com Logo

Medasource

Location Icon

Location:
United States , Sacramento

Category Icon
Category:

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

40.00 USD / Hour

Job Description:

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

Additional Information:

Job Posted:
February 16, 2026

Work Type:
Remote work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Reimbursement Analyst III

Reimbursement Analyst Iii

The Reimbursement Analyst III supports complex reimbursement and cost reporting ...
Location
Location
United States , Sacramento
Salary
Salary:
50.00 - 57.00 USD / Hour
medasource.com Logo
Medasource
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 2+ years of experience in healthcare reimbursement with direct cost reporting and general ledger integration
  • Experience preparing Medicare cost reports (CMS-2552-10) with ownership of worksheets, allocations, and audit support
  • Experience with HCAI (OSHPD) reporting in large or multi-facility health systems
  • Strong experience working with general ledger data, cost allocations, and reconciliation to financial statements
  • Proven experience in cost report preparation, not revenue cycle, billing, or AR functions
  • Strong knowledge of CMS, Medicare, and Medi-Cal reimbursement methodologies
  • Experience reviewing audit adjustments and managing appeals with regulatory agencies
  • Ability to analyze regulatory guidance and build reimbursement impact models
  • Experience supporting audits, regulatory filings, and compliance documentation
Job Responsibility
Job Responsibility
  • Supports complex reimbursement and cost reporting functions for a large healthcare system in a fully remote capacity
  • Focused on true reimbursement work including Medicare and Medi-Cal cost report preparation, HCAI filings, and reconciliation to general ledger and financial statements
  • Ownership of cost report worksheets, cost allocations, audit support, and management of audit adjustments and appeals
  • Serves as a subject matter expert in reimbursement methodologies and provides financial impact modeling based on regulatory changes
  • Partners closely with accounting and finance teams to ensure accurate cost reporting, compliance, and timely regulatory submissions
What we offer
What we offer
  • Competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage
  • 401k plan with company match fully vested after eligibility
  • Paid time off
  • Sick time
  • Paid company holidays
  • Employee Assistance Program (EAP) with virtual counseling, financial services, legal services, life coaching
  • Fulltime
Read More
Arrow Right

Contract Compliance Analyst III

The Contract Compliance Analyst III will facilitate contract implementation and ...
Location
Location
United States , Madison
Salary
Salary:
51000.00 - 84000.00 USD / Year
exactsciences.com Logo
Exact Sciences
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 3+ years of experience in billing/reimbursement, coverage, claims, and appeals
  • Demonstrated understanding of public and private Managed Care payers and reimbursement process
  • Demonstrated understanding of market-related issues, contract basics, product coverage, and pull through rationale
  • Proficient with Excel and Epic or similar database
  • demonstrated ability to maintain competency levels
  • Demonstrated ability to perform the Essential Duties of the position with or without accommodation
  • Applicants must be currently authorized to work in country where work will be performed on a full or part-time basis. We are unable to sponsor or take over sponsorship of employment visas at this time.
Job Responsibility
Job Responsibility
  • Develop communication for contracts, amendments, and notifications for the internal Revenue Cycle Team (RCT) customers and collaborate with the Field Managed Care team in negotiations with payers for operational optimization
  • Play a role in the development and maintenance of a contract database and contract management system, working with the credentialing and legal teams
  • Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios specific to payers and across payer segments
  • including Medicare Advantage, Blues, Medicaid, etc.
  • Collaborate with RCT Managers and specialists to develop and leverage relationships with billing operations staff and payers when resolving claim adjudication issues, both contractual and non-contractual
  • Support execution of pull-through plans to meet quarterly/annual revenue recovery goals
  • Identify broad revenue opportunities that span a particular customer segment
  • including utilizing Content Management Systems (CMS) for noncontracted Managed Medicare non-payments and the Employer Coalition initiative
  • Consistently identify opportunities to recover revenue
  • Collaborate with the Managed Care team to identify and prioritize plan(s) utilizing key payers for targeted efforts to impact coverage policy decisions
What we offer
What we offer
  • paid time off (including days for vacation, holidays, volunteering, and personal time)
  • paid leave for parents and caregivers
  • a retirement savings plan
  • wellness support
  • health benefits including medical, prescription drug, dental, and vision coverage
  • bonus eligible.
  • Fulltime
Read More
Arrow Right

Policy & Planning Analyst III

The Wyoming Department of Transportation is seeking a Policy & Planning Analyst ...
Location
Location
United States , Cheyenne
Salary
Salary:
32.52 - 36.13 USD / Hour
dot.state.wy.us Logo
Wyoming Department of Transportation
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's Degree (typically in Business)
  • 0-3 years of progressive work experience (typically in Business) with acquired knowledge at the level of a Policy & Planning Analyst I
  • OR 4-6 years of progressive work experience (typically in Business) with acquired knowledge at the level of a Policy & Planning Analyst I
  • Ability to distill complex federal-aid program requirements into clear, actionable guidance for diverse stakeholders and local partners
  • A foundational mastery of contract requirements, including the ability to interpret, draft, and oversee legal and cooperative agreements
  • Comprehensive knowledge of legislative, executive, and federal government processes, coupled with a strong command of complex financial transactions and compliance frameworks
  • Travel is required in this position
Job Responsibility
Job Responsibility
  • Serves as a liaison to Local Public Agencies (LPAs), providing expert guidance on funding availability, application processes, and program requirements at public meetings and outreach events
  • Manages the solicitation and vetting of project proposals and draft formal Cooperative Agreements that define roles, responsibilities, and legal adherence between WYDOT and local partners
  • Coordinates with the FHWA and internal WYDOT programs to interpret and apply federal (CFR) and state regulations, ensuring all local projects meet strict compliance, environmental, and engineering standards
  • Reviews and approves contract documents, bid processes, and project awards to verify transparency, completeness, and adherence to procurement laws
  • Audits reimbursement requests for compliance and monitors project budgets and progression to ensure fiscal accountability and timely delivery
  • Performs construction monitoring and lead final acceptance processes to certify that projects are completed according to specifications and safety standards
  • Develops standardized compliance tools (checklists/manuals) and lead certification training programs designed to eliminate deficiency trends and improve LPA performance
  • Facilitates selection committees, manages the nomination process, and presents formal project recommendations to the Transportation Commission
  • Supports participants in programs that are under-performing, and assists the LPA in successfully executing their project
  • Advertises and gathers proposals from the LPAs for projects, working with LPAs to ensure proposals are proper
What we offer
What we offer
  • $2,000 Hiring Bonus
  • Comprehensive health, dental, and vision insurance
  • Paid vacation, sick leave, FMLA, and holidays
  • Retirement - Pension and 457B plans
  • Flexible schedules and work-life balance options
  • Fulltime
Read More
Arrow Right

Healthcare Data Analyst III

Bright Vision Technologies is a forward-thinking software development company de...
Location
Location
United States
Salary
Salary:
Not provided
bvteck.com Logo
Bright Vision Technologies
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor’s degree or equivalent experience
  • 4+ years experience
  • Medicare, Medicaid, and Marketplace analytics
  • Strong SQL (complex queries, joins)
  • Advanced Excel (Pivot Tables, Power Query, VLOOKUP/XLOOKUP)
  • Power BI (DAX, Power Pivot)
  • Knowledge of DRG, APC, EAPG payment methodologies
  • Managed Care / Medical Economics experience
Job Responsibility
Job Responsibility
  • Analyse healthcare data to support cost-of-care, reimbursement, and medical economics decisions
  • Partner with business and clinical teams to deliver insights that improve financial and clinical outcomes
  • Analyse claims, provider, member, and encounter data
  • Develop and maintain reports using SQL, Excel, and Power BI
  • Identify trends, anomalies, and cost drivers
  • perform root-cause analysis
  • Support medical economics initiatives (MLR, QAI, ROI, pricing)
  • Present insights to non-technical stakeholders
  • Collaborate cross-functionally and guide junior analysts
What we offer
What we offer
  • medical
  • 401(k)
  • PTO
  • tuition reimbursement
  • 8% bonus
  • Fulltime
Read More
Arrow Right

Help Desk Analyst III

In this hands-on role, you will provide technical support and troubleshooting se...
Location
Location
United States , Norman
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum of 5-7 years of experience in IT support, including break/fix environments
  • Strong expertise in Microsoft Office 365, Active Directory, and configuration management
  • Familiarity with Android and Apple devices, as well as Mac and PC hardware
  • Proficiency in Cisco and Citrix technologies
  • Ability to troubleshoot complex technical problems independently and think critically
  • Excellent communication skills to interact effectively with clients and team members
  • Hands-on experience with deployments, server maintenance, and network configurations
  • Must possess a valid driver’s license and ability to travel to client sites using a personal vehicle
Job Responsibility
Job Responsibility
  • Provide on-site and remote technical support for clients, ensuring timely resolution of hardware, software, and network issues
  • Install, configure, and troubleshoot internet systems for residential and commercial customers
  • Perform hands-on tasks such as cable troubleshooting and ladder work to maintain connectivity
  • Manage and support servers, networks, workstations, and Office 365 applications
  • Collaborate with vendors and clients to ensure seamless IT service delivery
  • Conduct system upgrades and migrations to improve infrastructure performance
  • Maintain detailed documentation of issues, solutions, and client interactions
  • Deliver exceptional customer service by communicating technical solutions in a clear and precise manner
  • Travel to client locations using personal vehicles and maintain accurate mileage records for reimbursement
  • Ensure compliance with background checks, mandatory pre-employment screenings for all candidates, and company policies
What we offer
What we offer
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan
  • Fulltime
Read More
Arrow Right
New

Loans Executive

A vacancy has arisen within Admiral Money for a Loans Executive within our growi...
Location
Location
United Kingdom , Cardiff
Salary
Salary:
Not provided
admiralgroup.co.uk Logo
Admiral Group Plc
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Experience in a customer-facing role
  • Ability to communicate with customers via telephone, email and webchat
  • Experience working accurately within process-driven or regulated environments
  • Strong attention to detail and accurate data entry skills
  • Ability to use multiple IT systems simultaneously
  • Good numeracy and PC skills
Job Responsibility
Job Responsibility
  • Communicating with customers via telephone, email and webchat, guiding them through the loan application process and supporting queries or changes throughout the loan lifecycle
  • Delivering first-class customer service while maintaining high quality and regulatory standards in line with individual and departmental objectives
  • Making a positive impact through customer interactions and contributing to a supportive, engaging workplace culture
  • Adapting quickly to change in a fast-paced, growing business environment
  • Playing an active role as we explore and develop new communication methods
What we offer
What we offer
  • 33 days holiday (including bank holidays) increasing to a maximum of 38 days
  • option to buy or sell up to an additional five days of annual leave
  • up to £3,600 of free shares each year after one year of service
  • Fulltime
Read More
Arrow Right
New

Senior Multi-Utility Designer - Variations

As a Senior Multi-Utility Designer - Variations, you will be responsible for man...
Location
Location
United Kingdom , London
Salary
Salary:
Not provided
socialvalueportal.com Logo
Social Value Portal Ltd
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Multi-Utility Design Experience
  • HNC / Relevant Degree
Job Responsibility
Job Responsibility
  • Team Leadership, Coaching and People Management - Provide effective line management to Designers, Intermediate and Trainee Designers, offering day to day coaching, technical guidance and operational support while managing people related responsibilities and developing team capability
  • Design Variation Assessment and Design Updates - Review Design Variation Orders, assessing technical and commercial impacts, creating DVO records in simPRO and producing updated designs and documentation with full traceability
  • Quotation Updates and Commercial Documentation - Prepare revised quotation documentation including BOQs, FS1s and DVO quotations, ensuring technical scope, cost adjustments and commercial terms are accurately reflected and recorded
  • Technical Validation, Commercial Approval and Client Issue - Coordinate technical validation and commercial approval of updated designs and documentation, incorporating feedback and issuing final DVOs to clients through to acceptance and construction handover
  • Design Approvals, Compliance and Project Handover - Prepare and manage updated design approval packs for electricity, gas and water networks, ensuring compliance with GIRS, NERS and WIRS requirements, issuing Approved for Construction drawings and supporting a smooth handover to construction teams.
  • Fulltime
Read More
Arrow Right
New

Ca-Wa Private Mortgage Banker

Location
Location
United States , San Rafael
Salary
Salary:
Not provided
https://www.wellsfargo.com/ Logo
Wells Fargo
Expiration Date
June 11, 2026
Flip Icon
Requirements
Requirements
  • 2+ years of Private Mortgage Banking Sales experience, or equivalent demonstrated through one or a combination of the following: work experience, training, military experience, or education
  • Basic Microsoft Office skills
  • Documented retail residential mortgage fundings over the past 12 months referred primarily from established, local, external sources
  • Excellent verbal, written, and interpersonal communication skills
  • Mortgage industry experience
  • Knowledge and understanding of sales prospecting and generating referrals
  • Customer service experience
  • Experience working with high net-worth clients
Job Responsibility
Job Responsibility
  • Participate in soliciting residential mortgages from various sources
  • Produce high quality jumbo loans which are compliant and provide excellent customer service
  • Build relationships focused on affluent borrowers with realtors, builders, financial professionals, bank stores, past customers, and other non-traditional sources
  • Develop and maintain a high degree of visibility for Wells Fargo Home Mortgage in the marketplace
  • stay informed of mortgage industry trends and developments in the assigned market
  • Present recommendations for producing loans and exercise some independent judgment while developing understanding of and adherence to Private Mortgage Banking Sales functional area, policies, procedures, compliance requirements, and generating loans
  • Understand real estate appraisals, title reports, and real estate transactions
  • Receive customer applications, quote the rate and points, and complete follow-up activities with the registration lock-in
  • analyze and offer mortgage loan products based on client needs
  • Review and analyze low to moderately complex financial and credit data
What we offer
What we offer
  • Health benefits
  • 401(k) Plan
  • Paid time off
  • Disability benefits
  • Life insurance, critical illness insurance, and accident insurance
  • Parental leave
  • Critical caregiving leave
  • Discounts and savings
  • Commuter benefits
  • Tuition reimbursement
  • Fulltime
Read More
Arrow Right