Epic Reimbursement Contracts Analyst (Revenue Cycle)

Baylor Scott & White Health; Annapolis (MD); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health benefits

401(k) match up to 5%

Tuition Reimbursement

PTO accrual from Day 1

Job summary

Baylor Scott & White Health in Annapolis is seeking an experienced 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).

You will monitor contract performance, identify underpayments and revenue opportunities, and collaborate with cross-functional teams including Managed Care, Revenue Cycle, IT, and payer representatives to resolve issues and ensure

Qualifications

• Bachelor's degree or equivalent experience required.
• Five years of experience in Managed Care, Government Finance, Revenue Cycle, Billing, or related healthcare field.
• Experience with CMS or Texas Medicaid Programs preferred.
• Experience in Epic HB/PB or other EHR software required.
• Knowledge of business office operations and troubleshooting in a healthcare setting.

Responsibilities

• Configure payer reimbursement contracts in Epic HB and 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 loaded in Epic HB/PB.
• Research reimbursement discrepancies and collaborate with multiple departments and payer representatives 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 related teams.
• Maintain knowledge of CMS, Medicare, and Medicaid reimbursement rules and methodologies.

Skills

Managed Care

Revenue Cycle

Billing

EHR software experience

Application troubleshooting

Education

Bachelor's degree or equivalent experience

Tools

Epic HB/PB

Epic Billing

EMR systems

Job description

Baylor Scott & White Health in Annapolis is seeking an experienced 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).

You will monitor contract performance, identify underpayments and revenue opportunities, and collaborate with cross-functional teams including Managed Care, Revenue Cycle, IT, and payer representatives to resolve issues and ensure