Accounting Reimbursement Analyst II

Position Type

Full Time, non-exempt employee.

Commensurate with experience.

This position based onsite at our Dallas, TX Service Center and may offer a hybrid work option after a 90-day probationary period (not fully remote).

Ensign Services, Inc. ("ESI") is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees.

ESI is known as the "Service Center" and provides the facilities and leaders it serves with "back‑office" support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day‑to‑day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource – our people.

We take our core values of Celebration
, Accountability
, Passion for Learning
, Love One Another
, Intelligent Risk Taking
, Customer Second
, and Ownership ("CAPLICO") seriously. We want an individual in this role who will demonstrate these values through actions and words.

The Accounting Reimbursement Analyst II plays an important role in supporting Medicare and Medicaid reimbursement analysis. This position works largely independently while staying connected to a collaborative team environment. In this role, you will prepare and complete Medicare and Medicaid cost reports, analyze financial and operational data, and support reimbursement‑related functions within the accounting department. You will also develop expertise in Medicaid reporting for assigned states and help maintain financial models used for rate setting and special payment programs.

This role is ideal for someone with a strong accounting foundation, solid analytical skills, and the ability to work independently while contributing to team success. You will partner with a growing client base across the U.S. to deliver accurate, timely reimbursement analysis and reporting.

If you’re looking to grow your expertise in reimbursement analysis while making a meaningful impact, we encourage you to apply today!

• Prepare Medicare and Medicaid cost reports across multiple states, ensuring accuracy and compliance with state and federal requirements.
• Analyze Medicaid reimbursement rates on a quarterly or annual basis, evaluating the financial impact of state regulations and proposed audit adjustments.
• Review payment and financial reports to identify, assess, and communicate cost report adjustments, including impacts to asset and liability accounts.
• Collaborate with state auditors and regulatory agencies, responding to inquiries and supporting audit processes.
• Analyze key balance sheet and income statement accounts, including accrued expenses and revenue accounts related to reimbursement.
• Reconcile receivable and payable accounts related to Medicare and Medicaid settlements, including bad debt.
• Stay current on changes to Medicare and Medicaid regulations, reimbursement methodologies, and rate impacts to ensure ongoing compliance and accuracy.
• Review monthly occupancy reports and support occupancy‑related calculations used in reporting.
• Collaborate closely with service center accounting teams, including payroll, accounts payable, accounts receivable, tax, general ledger, and financial reporting, to support accurate and timely financial processes.
• Provide support for ad hoc projects and special initiatives as business needs arise.

• Bachelor’s degree or Masters in Accounting or Finance (or equivalent experience), preferred.
• Minimum of 2‑3 years of experience in accounting or reimbursement, required.
• Proficiency with standard office software, including Outlook and Word, with advanced Excel skills, including experience working with large data sets and proficiency with formulas such as VLOOKUP, HLOOKUP, and XLOOKUP, as well as nested…