Epic Contract Analyst

About the role

This fully remote position implements new payer contracts and contract changes, cultivates and maintains payer and internal customer relationships, develops departmental resources and tools, and assists with payer payment management and reporting. Some annual on-site team meetings may be required when financials allow. Candidates residing or planning to reside in California, Connecticut, Hawaii, Illinois, Maine, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Virginia, Vermont, or Washington are not currently being considered.

Responsibilities

• Interprets payer contract terms and payment methodologies for the creation, maintenance, and programming of Epic’s financial system and Contract Management tool to ensure accurate calculation of expected payments based on negotiated contract terms at the time of billing for professional, hospital, and ancillary services.
• Supports contract negotiations through review of contract language, development of new payment models, modeling of proposed contract terms and rates, and making recommendations to department management.
• Interacts with internal and external parties regarding communication, questions about rates and terms, rate structure development, and reconciliation of contract provisions and disputes.
• Responsible for the ongoing, timely maintenance of professional, hospital, and ancillary provider fee schedules.
• Audits payer claims to ensure accuracy of system build and compliance with contract terms, investigating systematic payment issues identified by department analyses or communicated by leadership.

Requirements

• Demonstrated experience working in a healthcare or managed care setting with a specific background in complex managed care and government contract modeling, building, and maintenance for providers including health systems, physicians, hospital organizations, and other ancillary facilities.
• Ability to obtain Epic Resolute Hospital and Professional Billing Expected Reimbursement Contract Certifications within three months of hire date and maintain while in this role.
• Demonstrated patient accounting experience.
• Demonstrated extensive experience with healthcare reimbursement methodologies (managed care and government payers).

Preferred Qualifications

• Bachelor's degree in finance, business, or related field from an accredited university.
• Epic Resolute Hospital and Professional Billing Expected Reimbursement Contracts certification and experience.
• Experience with revenue cycle, patient accounting, third-party payer contracting, and/or payer contract modeling systems.

Skills

• Accountability
• Learning Quickly
• Emerging Technologies
• Workflow Design
• Communication
• Professional Etiquette
• Commercial Insurance
• Government Programs
• Teamwork
• Work Collaboratively

Physical Requirements

• Ongoing need to see and read information, labels, monitors, and documents, and assess customer needs.
• Frequent interactions requiring clear communication and understanding of spoken information, needs, and issues.
• Manual dexterity to manipulate complex and delicate equipment, including frequent computer, phone, and cable setup.
• Ability to remain sitting or standing for long periods.
• Expected to lift and utilize full range of movement to transport, pull, and push equipment, including heavy items.
• Work on hands and knees and bend to set up, troubleshoot, lift, and carry supplies and equipment.

Schedule

Monday - Friday, 8AM - 5PM.

Pay

Hourly rate: $34.26 - $53.96, dependent upon experience.

Benefits

Comprehensive benefits package covering mind, body, and spirit, including programs for living healthy, happy, secure, connected, and engaged. Learn more about our benefits package.