Epic Revenue Cycle Analyst: Managed Care Contracts
Baylor Scott & White Health
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Benefits offered by this job
Job summary
Baylor Scott & White Health is hiring for a contract-focused role within the Revenue Cycle to support managed care and government reimbursement contracts in Epic Hospital Billing and Professional Billing. You will monitor contract performance and identify underpayments and revenue opportunities.
Applicants should have 5+ years in healthcare finance, familiarity with CMS/Medicaid, and experience with Epic HB/PB or similar EHR systems.
Qualifications
- Five years of experience in Managed Care, Government Finance, Revenue Cycle, Billing, or related healthcare fields.
- Experience with CMS or Texas Medicaid Programs.
- Experience in Epic HB/PB or other EHR software.
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 in Epic HB and PB.
- Research reimbursement discrepancies and coordinate 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, and SOPs.
- Explain contract terms and Epic reimbursement logic to Revenue Cycle and related teams.
- Stay updated on CMS, Medicare, Medicaid rules and rate methodologies.
Skills
Education
Tools
Job description
Baylor Scott & White Health is hiring for a contract-focused role within the Revenue Cycle to support managed care and government reimbursement contracts in Epic Hospital Billing and Professional Billing. You will monitor contract performance and identify underpayments and revenue opportunities.
Applicants should have 5+ years in healthcare finance, familiarity with CMS/Medicaid, and experience with Epic HB/PB or similar EHR systems.
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