Position Summary:

The Healthcare Revenue and Grants Accountant is a key financial professional responsible for managing the full lifecycle of grant funding, program finances, and healthcare revenue operations for the St. Croix Tribal Health Clinic. This role ensures financial integrity, regulatory compliance, and strategic support of clinic programs through accurate accounting, analysis, and reporting.

This position operates with a high degree of independence and requires a strong understanding of healthcare revenue cycle processes, including the integration of financial systems with Electronic Health Record (EHR) platforms. The Accountant serves as a critical liaison between finance, clinical programs, billing operations, and external funding agencies while supporting the delivery of community-centered healthcare services.

Essential Functions:

Oversee financial management of grants, contracts, and clinic programs, ensuring compliance with federal, state, tribal, and regulatory requirements
Prepare, monitor, and reconcile budgets, expenditures, drawdowns, and general ledger activity, including monthly and year-end close processes
Manage revenue cycle functions by coordinating with billing and clinical teams to ensure accurate charge capture, collections, and reconciliation of third-party payers
Analyze financial and revenue data to identify trends, variances, and discrepancies, and provide recommendations to support program and leadership decision-making
Prepare financial reports, support audits, and serve as a liaison between finance, program staff, and external agencies while maintaining strict confidentiality

Health Revenue and Grants Accountant Job Duties:

Manage financial activity for assigned grants, contracts, and clinic programs, ensuring compliance with federal, state, and tribal requirements (including 2 CFR Part 200)
Prepare, monitor, and reconcile grant budgets, expenditures, and drawdowns
Track program spending to ensure alignment with approved budgets and funding restrictions
Prepare financial reports, reimbursement requests, and supporting documentation for granting agencies
Support revenue cycle activities including billing, collections, and reconciliation of third-party payers (Medicaid, Medicare, private insurance)
Work with billing and clinical teams to ensure accurate charge capture and alignment between EHR data and financial records
Reconcile accounts receivable, cash postings, and other revenue transactions to the general ledger by fund and funding source
Analyze revenue trends and investigate discrepancies related to claims, denials, and reimbursement variances
Utilize and support financial data derived from EHR and practice management systems to ensure accurate reporting and compliance
Collaborate with staff using EHR systems such as NextGen, Pioneer, Alleva, or similar platforms to validate data integrity and optimize revenue capture
Investigate and resolve discrepancies affecting financial reporting and revenue
Prepare and post journal entries; maintain general and subsidiary ledgers
Perform monthly reconciliations of accounts including bank accounts, receivables, payables, and grant balances
Prepare monthly, quarterly, and annual financial reports for leadership
Monitor program budgets, analyze variances, and provide recommendations to program managers
Ensure compliance with GASB standards, federal grant requirements, and tribal financial policies
Support audits by preparing documentation and responding to auditor inquiries, including single audits
Serve as liaison between finance, program staff, billing, and external agencies
Maintain strict confidentiality in accordance with HIPAA and organizational policies
Perform other duties as assigned related to the position

Note: The essential functions are intended to describe the general contents of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent’s immediate manager.

Type of Supervisory Responsibilities: N/A

Supervisory Responsibilities: N/A

Directly Reporting to: Health CFO

Matrix of INDIRECT Reporting: St. Croix Tribal Council

Scope and Complexity:

Interacts with all levels of management and employees; often trusted with maintaining confidentiality and relaying highly sensitive information, and appropriate application of business operations and practices.

Physical Demands/Environment Factors:

Requires extensive sitting with periodic standing and walking.
May be required to lift up to 50 pounds.
Requires significant use of personal computer, phone and general office equipment.
Need ability to communicate effectively through reading, writing, and speaking in person or on the telephone.
May require off-site travel.

Minimum Qualifications:

Bachelor’s degree in Accounting, (required)
Minimum of 3–5 years of progressively responsible accounting experience, preferably in governmental, tribal, healthcare, or grant-funded environments
Working knowledge of Governmental Accounting Standards Board (GASB) principles
Experience with fund accounting and multi-funding source environments
Knowledge of federal grant regulations (Uniform Guidance / 2 CFR Part 200)
Knowledge of healthcare revenue cycle processes and third-party billing
Experience working with or supporting data from Electronic Health Record (EHR) and/or practice management systems
Strong proficiency in Microsoft Excel and financial analysis
Demonstrated ability to manage multiple programs, grants, and reporting requirements
Must maintain strict confidentiality and demonstrate reliability and professionalism

Preferred Qualifications:

Certified Public Accountant (CPA) license preferred or ability to obtain within a specified timeframe
Experience working in a tribal government or tribal healthcare system
Familiarity with federal healthcare funding sources (IHS, HRSA, SAMHSA) and 638 programs
Demonstrated experience with healthcare revenue cycle processes, including billing, claims management, and third-party reimbursement (Medicaid, Medicare, private insurance)
Experience working with Electronic Health Record (EHR) and/or practice management systems such as NextGen, Pioneer, Alleva, or similar platforms
Experience integrating or reconciling data between EHR/practice management systems and accounting/financial systems to ensure accuracy of revenue reporting and financial statements
Experience with accounting systems such as MIP or similar financial management or fund accounting systems
Experience working across both financial management systems (e.g., MIP) and EHR platforms, with the ability to analyze, reconcile, and validate data between clinical and financial systems
Experience supporting audits, including single audits
Knowledge of indirect cost rates and cost allocation methodologies

Native American Preference Given in Accordance with P.L. 93-638 and Amendments

The offer is conditional based on confirmation that the candidate meets all specific criteria required (background check, driver’s insurability verification, references, identity verification, and other applicable requirements).

Pay: $35.78 per hour

Benefits:

Dental insurance
Employee discount
Health insurance
Life insurance
On-site gym
Paid sick time
Paid time off
Parental leave
Vision insurance

Work Location: In person

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Health Revenue and Grants Accountant