PB HB Contracts Analyst

Medasource; United States; Remote; USD 85,000 - 120,000; Full time

Job summary

An established industry player is seeking a PB HB Contracts Analyst to manage and optimize contracts within a dynamic healthcare environment. This role is crucial for ensuring billing integrity and supporting revenue cycle operations. You will be responsible for loading and maintaining contracts, analyzing payment discrepancies, and providing insights for contract negotiations. If you have a strong background in financial analysis and healthcare contracts, this is a fantastic opportunity to make a significant impact in a collaborative and innovative setting.

Benefits

Medical Insurance

Vision Insurance

Qualifications

• 5-8 years in financial analysis within healthcare.
• Experience with EPIC contracts and healthcare regulations.

Responsibilities

• Load and maintain contracts in the management system.
• Analyze payment discrepancies and contract performance.

Skills

Contract Management

Financial Analysis

Healthcare Industry Knowledge

Problem Solving

Analytical Skills

Education

Bachelor’s Degree in Business

Bachelor’s Degree in Finance

Bachelor’s Degree in Health Care Management

Tools

EPIC

Contract Management Systems

Job description

This range is provided by Medasource. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$85,000.00/yr - $120,000.00/yr

Position: PB HB Contracts Analyst

Location: Remote, must not reside in CA, CO, MA***

Full time

Summary:

The PB HB Contracts Analyst is responsible for all loading, modeling, support, and maintenance of the contracts and fee schedules within the contract management system. This includes Federal and Managed Care contracts for all Health Systems entities; facility, professional, home care, infusion, pharmacy, etc. Provides key Revenue Cycle support and insight to Managed Care Office for contract negotiation considerations. This role supports implementation of new and upgraded systems/releases or new/revised operational procedures. The position includes the capability to model, support and operationalize contracting methodologies to understand and support payment variance analysis.

Functions

• Responsible for accurately and timely loading, testing, and maintaining all fee schedule and contract terms into the contract management system to maintain patient care and billing integrity.
• Assists with the analysis and resolution of payment discrepancies, and thoroughly tests and validates loaded contracts to effectively maximize both patient care and revenue cycle needs
• Completes the prospective modeling of proposed contracts, scenarios, and other changes potentially impacting reimbursement to support day to day operations and contract negotiations
• Proactively, or upon request, reviews contract performance, identifies improvement opportunities, and models impact for reimbursement review to inspire enhanced continuous improvement
• Generates periodic (monthly, quarterly, etc.) standard reports and surveys in accordance with the established schedule to stay abreast of market trends
• Analyzes, compares and determines the financial impact of Medicare/Medicaid/ TriCare and commercial fee schedule and contract changes and utilize the data to support managed care contract negotiations and variance discrepancies.
• Monitors contract-payment variances and supports leadership for addressing payment issues, and also maintains accuracy of expected reimbursement.
• Prepares and provides contract reimbursement summaries for department needs and identifies contract opportunities
• Responsible for modeling, loading, and testing EPIC contracts.
• Monitor federal and state regulations, interpret contract language and work with payer to ensure updates are provided timely.

Knowledge:

• Knowledge of and experience with the drafting of contracts and related negotiations, contract/case/document management systems and contracting strategies is required.
• Knowledge of the healthcare industry and applicable federal and state regulations.
• High level drafting skills for articulating ideas in a concise, specific, and straight forward manner and in a timeframe that supports a high volume of work.
• Excellent reading comprehension to discern and correct ambiguities and inconsistencies, and to ensure the intended meaning in conveyed in written documents.
• Exercise a high level of independent analytical and problem solving to develop contracting strategies to provide a competitive advantage to the hospital system for the purchase of healthcare equipment, products and services
• Possesses a working knowledge and understanding of managed health care contracts and have experience with contract modeling and contract management systems
• Possesses strong financial analysis skills and project management skills
• Candidate must have knowledge in hospital and professional charging and reimbursement.

Education:

Bachelor’s degree is required. Preferably in Business, Accounting, Finance, Health Care Management or associated field of study.

Certifications:

Required to have completed training and certification in these EPIC application modules – Resolute Hospital Billing Expected Reimbursement Contracts Administration, Resolute Professional Billing Reimbursement Contracts.

Work Experience:

· 5-8 years’ experience working in a decision support or financial analysis position with responsibility in a healthcare provider environment

· 3 years’ experience maintaining, updating, and loading EPIC contracts

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

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