Analyst-Business Senior

Overview

Job Description

Summary

Insures payor contracts are up-to-date in Epic so that expected payment amounts calculates correctly. Provides analytical support related to reimbursement to all levels of the organization. Assist hospital Business Offices in working payment variances in a timely manner. Assist with month end close process for Managed Care. Works to support the system in regards to insurance contracts and maintenance. This position is under the general direction of the Director of Managed Care-Finance.

Responsibilities

• Using Epic contract modeling software, create and maintain complete and accurate reimbursement models based on payer agreements including Medicare, Medicaid, Blue Cross, and other payors
• Perform extensive review, analysis and interpretation of contract modeling results. Provide results of the analysis and impact contract corrections will have on current AR.
• Support contract negotiations using contract-modeling software to evaluate and create reimbursement proposals.
• Maintain collaborative relationships with Managed Care Contracting and Patient Accounting departments by sharing information regarding payor financial arrangements.
• Research and understand Medicare, Medicaid, and commercial payment methodologies and industry developments.
• Progress in knowledge of healthcare payment methodologies and contract modeling.
• Performs other duties as assigned.
  
  

Requirements, Preferences And Experience

Education

• Required: Bachelor's Degree in accounting or finance
• Preferred: Master's Degree in business, healthcare administration, accounting or finance
  
  

Experience

• Required: 5+ years Healthcare revenue cycle, accounting or finance, and information system related field.
• Preferred: Experience in Managed Care and payor contracting language, or reimbursement, or related field.
  
  

Special Skills

• Required: Uses effective project management skills, including project planning and tracking. Has an understanding of process improvement, Possesses strong analytical skills.