Epic Billing Analyst II - Reimbursement & Contracts

Baylor Scott & White Health; United States; On-site; USD 85,000 - 125,000; Full time

Benefits offered by this job

Health benefits

401(k) match up to 5%

Tuition Reimbursement

PTO accrual Day 1

Job summary

Baylor Scott & White Health is hiring for a role focused on managing payer reimbursement contracts within Epic Hospital Billing (HB) and Professional Billing (PB). You will monitor contract performance, identify underpayments, and collaborate with multidisciplinary teams to optimize revenue cycle outcomes.

Ideal candidates bring 5+ years in managed care or related fields, strong CMS/Medicaid experience, and proficiency with Epic HB/PB or other EHR systems.

Qualifications

• Bachelor's degree or equivalent work experience.
• 5 years in managed care, government finance, revenue cycle, or related fields.
• Experience with CMS or Texas Medicaid programs.
• Experience with Epic HB/PB or other EHR systems.
• Strong understanding of payer reimbursement and contract terms.

Responsibilities

• Configure payer reimbursement contracts in Epic HB/PB.
• Translate managed care contracts, reimbursement terms, exclusions, carve-outs, stop-loss provisions, fee schedules, and payment methodologies.
• Develop test scenarios to ensure accurate reimbursement calculations in Epic HB/PB contracts.
• Investigate reimbursement discrepancies and collaborate with stakeholders for resolution.
• Maintain payer and plan mapping to connect contracts to payers, plans, products, service areas, location, and billing entities.
• Maintain build specs, testing evidence, approvals, change controls, and SOPs.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and other teams.
• Stay updated on CMS, Medicare, and Medicaid reimbursement rules and policy updates.

Skills

Managed Care

Revenue Cycle

Billing

Team Collaboration

Education

Bachelor's degree or equivalent experience

Tools

Epic HB/PB

EHR systems

Job description

Baylor Scott & White Health is hiring for a role focused on managing payer reimbursement contracts within Epic Hospital Billing (HB) and Professional Billing (PB). You will monitor contract performance, identify underpayments, and collaborate with multidisciplinary teams to optimize revenue cycle outcomes.

Ideal candidates bring 5+ years in managed care or related fields, strong CMS/Medicaid experience, and proficiency with Epic HB/PB or other EHR systems.