Senior Accountant

Description

SUMMARY: Supports financial operations across multiple rural hospitals in a Critical Access Hospital (CAH) setting. This role ensures compliance with healthcare funding programs such as Disproportionate Share Hospital (DSH) payments, Uncompensated Care (UC) funding, and the Texas 1115 Medicaid Waiver, while working with internal leadership and state agencies to maintain financial accuracy. Strong hospital accounting experience and knowledge of CAH regulations are essential.

ESSENTIAL DUTIES AND RESPONSIBILITIES: 

• Maintain accurate general ledger activity and financial records for assigned CAH facilities
• Prepare and analyze monthly, quarterly, and annual financial statements
• Monitor budget-to-actual performance and perform variance analysis
• Oversee data collection, reporting, and compliance for state and federal supplemental payment programs, including:
• Texas 1115 Waiver Programs
• Disproportionate Share Hospital (DSH)
• Uncompensated Care (UC) Pools
• Coordinate with internal departments to gather appropriate program documentation
• Submit timely reports and supporting materials to state agencies
• Assist in the preparation of cost reports and participate in audit activities
• Work collaboratively with hospital leaders to ensure financial transparency and readiness
• Support internal and external audit processes
• All other duties as assigned

Requirements

EDUCATION and/or EXPERIENCE QUALIFICATIONS:

• Bachelor’s degree in Accounting, Finance, or a related field
• 3+ years of accounting experience, preferably in a hospital or healthcare setting
• Strong understanding of GAAP and financial reporting
• Experience working with or around CAH reimbursement, Medicare/Medicaid, or related programs
• Advanced Excel skills and familiarity with financial systems
• CPA or active pursuit of certification (Preferred)
• Prior experience with state and federal healthcare funding programs (DSH, UC, 1115 Waiver) (Preferred)
• Familiarity with cost-based reimbursement models and rural hospital operations (Preferred)