Epic Billing & Reimbursement Systems Analyst

Baylor Scott & White Health; Baton Rouge (LA); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health insurance

401(k) savings plan

Tuition Reimbursement

PTO accrual beginning Day 1

Job summary

Baylor Scott & White Health seeks a contract and reimbursement specialist to support managed care and government contracts within Epic Hospital Billing (HB) and Professional Billing (PB). You will monitor performance, identify underpayments, and pursue revenue opportunities with cross-functional teams.

Responsibilities include configuring payer contracts, translating terms, testing reimbursement calculations, and staying current with CMS/Medicare/Medicaid guidelines to ensure accurate payments

Qualifications

• Bachelor's degree or equivalent experience.
• 5+ years in Managed Care, Government Finance, Revenue Cycle, or related healthcare fields.
• Experience with CMS or Texas Medicaid programs.
• Experience with payer reimbursement and contract analysis.

Responsibilities

• Configure payer reimbursement contracts in HB and PB.
• Translate contract terms, exclusions, stop-loss provisions, fee schedules, and payment methodologies.
• Develop test scenarios to validate reimbursement calculations loaded in HB and PB contracts.
• Research reimbursement discrepancies and collaborate with stakeholders for resolution.
• Maintain payer and plan mapping to connect contracts to payers, plans, products, service areas, locations, and billing entities.
• Maintain build specifications, testing evidence, and change controls.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and other teams.
• Stay current on CMS, Medicare, and Medicaid reimbursement rules and policy updates.

Skills

CMS/Medicare/Medicaid knowledge

Payer reimbursement

Education

Bachelor's degree or equivalent experience

Tools

Epic HB/PB

Job description

Baylor Scott & White Health seeks a contract and reimbursement specialist to support managed care and government contracts within Epic Hospital Billing (HB) and Professional Billing (PB). You will monitor performance, identify underpayments, and pursue revenue opportunities with cross-functional teams.

Responsibilities include configuring payer contracts, translating terms, testing reimbursement calculations, and staying current with CMS/Medicare/Medicaid guidelines to ensure accurate payments