Epic Billing & Reimbursement Systems Analyst

Baylor Scott & White Health; Frankfort (KY); On-site; USD 85,000 - 115,000; Full time

Benefits offered by this job

Health benefits

401(k) match up to 5%

Tuition reimbursement

PTO accrual beginning Day 1

Job summary

Baylor Scott & White Health in Kentucky seeks a contract operations professional to support managed care and government reimbursement contracts within Epic HB and PB. You will configure payer contracts, translate terms, and develop test scenarios to ensure accurate reimbursements.

You will collaborate with Revenue Cycle, IT, and payer representatives, maintain payer mappings and documentation, and stay current with CMS/Medicare/Medicaid rules.

Qualifications

• Bachelor's degree or equivalent experience.
• 5 years of experience in Managed Care, Government Finance, Revenue Cycle, or related fields.
• Experience with CMS or Texas Medicaid programs.
• Experience in Epic HB/PB or another EHR software.
• Knowledge of healthcare business office operations.
• Strong application troubleshooting and problem-solving skills.
• Experience with payer reimbursement processes.

Responsibilities

• Configure payer reimbursement contracts in Epic HB and PB.
• Translate reimbursement terms, exclusions, carve-outs, stop-loss, fee schedules, and payments.
• Develop test scenarios for accurate reimbursement loading in Epic HB/PB.
• Research discrepancies and collaborate with cross-functional teams for resolution.
• Maintain payer and plan mapping linking contracts to payers, plans, products, service areas, location, and billing entities.
• Maintain build specifications, testing evidence, approvals, change controls, SOPs.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and related teams.
• Stay current with CMS, Medicare, and Medicaid reimbursement rules and policy updates.

Skills

Managed Care

Government Finance

Revenue Cycle

Billing

Healthcare operations

Application troubleshooting

Payer reimbursement

Education

Bachelor's degree or equivalent experience

Job description

Baylor Scott & White Health in Kentucky seeks a contract operations professional to support managed care and government reimbursement contracts within Epic HB and PB. You will configure payer contracts, translate terms, and develop test scenarios to ensure accurate reimbursements.

You will collaborate with Revenue Cycle, IT, and payer representatives, maintain payer mappings and documentation, and stay current with CMS/Medicare/Medicaid rules.