Epic Revenue Cycle Analyst — Managed Care & Reimbursement

Baylor Scott & White Health; Lansing (MI); Sur place; USD 65 000 - 95 000; Plein temps

Avantages offerts par ce poste

Immediate health and welfare benefits

401(k) with 5% match

Tuition Reimbursement

PTO accrual from Day 1

Résumé du poste

Baylor Scott & White Health is seeking an experienced Healthcare Billing 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 includes monitoring contract performance, identifying underpayments, and collaborating with payer representatives to optimize revenue opportunities. Strong Epic HB/PB knowledge is essential.

Qualifications

• Bachelor's degree or equivalent experience.
• Five years of Managed Care, Government Finance, Revenue Cycle, Billing, or related fields in healthcare.

Responsabilités

• 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 various teams for resolution.
• Maintain payer and plan mapping to ensure contracts connect to correct payers, plans, products, service areas, locations, and billing entities.
• Maintain build specifications, testing evidence, assumptions, approvals, change controls, and SOPs.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and other teams.
• Stay updated on CMS, Medicare, and Medicaid reimbursement rules and methodologies.

Connaissances

Healthcare billing experience

Formation

Bachelor's degree or equivalent experience

Outils

Epic HB/PB

Description du poste

Baylor Scott & White Health is seeking an experienced Healthcare Billing 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 includes monitoring contract performance, identifying underpayments, and collaborating with payer representatives to optimize revenue opportunities. Strong Epic HB/PB knowledge is essential.