Epic Reimbursement Systems Analyst

Baylor Scott & White Health; Hagåtña (GU); Presencial; USD 90 000 - 120 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health and welfare benefits

401(k) matching contributions

Tuition reimbursement

PTO from Day 1

Resumo da oferta

Baylor Scott & White Health is seeking a contract management specialist 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 and identifying underpayments and opportunities for revenue improvement.

Candidates should have 5+ years in Managed Care, Revenue Cycle, or related fields in healthcare, plus experience

Qualificações

• Bachelor's degree or 4 years of work experience above the minimum qualification.
• Five years of Managed Care, Government Finance, Revenue Cycle, Billing, or related healthcare fields.

Responsabilidades

• 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 in Epic HB/PB.
• Research 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 specifications, testing evidence, approvals, and change controls.

Conhecimentos

Managed Care experience

Revenue Cycle knowledge

Cross-functional collaboration

Formação académica

Bachelor's degree or equivalent experience

Ferramentas

Epic HB/PB

Descrição da oferta de emprego

Baylor Scott & White Health is seeking a contract management specialist 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 and identifying underpayments and opportunities for revenue improvement.

Candidates should have 5+ years in Managed Care, Revenue Cycle, or related fields in healthcare, plus experience