Sr. Internal Controls Analyst - Accounting

Clinics collect cash, checks, cards, insurance payments and third party financing every day, and every dollar has to travel from the patient to the practice management system (PMS), to the bank, to the general ledger.  This senior analyst follows that trail, finds where it breaks (missing, short, late, duplicate or misapplied deposits), and then owns the investigation from first flag to closure.  You will manage cases day to day and work directly with the insurance claims team, the Legal team and HR, and with outside forensic accountants when we bring them in.  You will also help us catch these problems earlier, not two years later.

• Trace deposits end to end. Match PMS collections to bank deposits and to the general ledger, using our reconciliation tools.  Explain every gap and timing difference.
• Investigate irregularities. Run down missing, short, delayed, duplicate or misapplied deposits, cash deposited to the wrong account, remote deposits with no PMS entry, orphan refunds, and payments that were deleted or changed after posting.
• Read the PMS audit trail. Analyze deletions, adjustments, in practice discounts, zero dollar procedures and off hours activity, and tie them to clinical notes, financing partners, card processors and insurance payments.
• Review completed bank reconciliations. Look for unusual activity, aged reconciling items and control weaknesses that the preparer may not see.
• Manage investigations. Own each case from intake to closure.  Set scope and priorities, assign and track work (including to the Analyst), keep the case file and timeline, preserve evidence with proper chain of custody, quantify exposure, and brief leadership in plain language on status and next steps.
• Work with the insurance claims team. Coordinate with insurance claims on payments, EFTs, denials, refunds and overpayments tied to a case, and on any claim or recovery that results.
• Work with Legal. Bring cases to Legal early, follow their direction on privilege, evidence handling and who can be contacted, and support outside counsel, forensic accountants and any law enforcement referral.
• Work with HR. Hand HR a factual, documented record when a case involves an employee, stay aligned on timing and next steps, and keep case details limited to those who need them.
• Partner with the PMS team and Treasury. Pull audit trails, bank and processor records, and financing statements needed to prove or disprove a pattern.
• Build early warning. Design monthly monitoring that flags patterns such as same day post and delete activity, cash payment deletions, large writeoffs and revenue that diverges from patient volume.  Run it across all practices.
• Strengthen controls. Recommend and document improvements to deposit procedures, deletion approvals and cash handling SOPs, and help train practice and field teams.
• Develop others. Coach the Internal Controls Analyst and share methods so the work does not depend on one person.

What you bring

Required

• Bachelor's degree in accounting, finance or a related field.
• 5 or more years in accounting, internal audit, forensic accounting, bank reconciliation or cash controls.
• Working fluency in a practice management or similar patient billing system (Dentrix a plus), able to read audit trails and payment ledgers.
• Advanced Excel and comfort with large data sets.
• Experience managing investigations from start to finish, including keeping a case file and briefing leadership.
• Experience working directly with Legal and HR on sensitive matters, and with insurance claims or a similar payer team.
• Clear writing.  Your documentation has to survive scrutiny from lawyers and auditors.

Preferred

• Familiarity with insurance claims, EFTs and healthcare payment flows, including patient financing.
• Experience leading or coaching a junior analyst.
• CPA or CFE.
• SQL, Power BI, Alteryx or similar tools.
• Experience across many locations and multiple bank accounts or processors.

How you will work

Methodical and discreet.  You document facts, not accusations ("fraud" means intent, and that call belongs to HR and Legal).  You are comfortable being the person who asks why a deposit does not match, including to senior people, and you do not tip off the people being reviewed.

• Time from first flag to a documented, quantified case, and number of open cases with a current status and next step.
• Handoffs to Legal, HR and insurance claims that need no rework.
• Share of practices covered by monthly monitoring.
• Deposit gaps found by the team before an outside party finds them.
• Control improvements implemented and tested.

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time.