Epic Contracts & Reimbursement Systems Analyst

Baylor Scott & White Health; Augusta (ME); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Tuition reimbursement

PTO accrual from day 1

Job summary

Baylor Scott & White Health is seeking a qualified professional to support the preparation, implementation, testing and maintenance of managed care and government reimbursement contracts within Epic Hospital Billing (HB) and Professional Billing (PB).

The role involves monitoring contract performance, identifying underpayments and revenue opportunities, and collaborating across Finance, IT and payer relations to optimize reimbursement.

Qualifications

• Bachelor's degree or equivalent required.
• 3–5 years of experience in Managed Care, Government Finance, Revenue Cycle or related healthcare field.
• Experience with CMS or Texas Medicaid programs.
• Experience with Epic HB/PB or other EHR software.

Responsibilities

• Configure payer reimbursement contracts in Epic HB/PB.
• Translate managed care contracts, reimbursement terms, exclusions, carve-outs, stop-loss, fees, and payment methodologies.
• Develop test scenarios to ensure accurate reimbursement calculations in HB/PB.
• Research reimbursement discrepancies; collaborate with Finance, Revenue Cycle, PFS, IT, and payer reps for resolution.
• Maintain payer and plan mappings to connect contracts to payers, plans, products, service areas and billing entities.
• Maintain build specs, testing evidence, approvals, change controls and SOPs.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and PFS teams.
• Maintain knowledge of CMS, Medicare and Medicaid reimbursement rules and regulatory updates.

Skills

Epic HB/PB experience

Payer reimbursement

Managed Care knowledge

CMS/Medicaid knowledge

Revenue Cycle

Education

Bachelor's degree

Tools

Epic HB/PB

Job description

Baylor Scott & White Health is seeking a qualified professional to support the preparation, implementation, testing and maintenance of managed care and government reimbursement contracts within Epic Hospital Billing (HB) and Professional Billing (PB).

The role involves monitoring contract performance, identifying underpayments and revenue opportunities, and collaborating across Finance, IT and payer relations to optimize reimbursement.