Remote Epic Contract Modeling Analyst

Nemours-Children; Jacksonville (FL); On-site; USD 90,000 - 130,000; Full time

Job summary

Nemours is seeking a Contract Modeling Analyst to join our team. This remote role requires residing in listed states and occasional travel.

The job focuses on implementing and maintaining Epic’s Contract Reimbursement system, including contracts, networks, payors, plans, and masterfiles to ensure accurate accounts receivable estimation. You will analyze current contractual states, support negotiations, and provide analyses to facilitate rate language and final contractual terms within the

Qualifications

• Bachelor’s degree or equivalent healthcare experience may be used in lieu of degree.
• Epic Professional Billing Reimbursement Contracts Certification and Epic Hospital Billing Expected Reimbursement Contracts Certification required.
• 5+ years of analytical experience with patient accounts or healthcare contract analysis and reimbursement.

Responsibilities

• Develop, test, implement and maintain Epic reimbursement contracts including rate and fee schedule adjustments, CPTs and provider and component updates to provide accurate estimation of accounts receivable per contract terms.
• Implement and test contract proposals from contract management teams using the EPIC modeling tool and provide executive summaries of financial impact and recommendations to leadership.
• Develop, test, implement and maintain Epic pricing contracts, including rate, fee schedules, CPTs, and provider adjustments as needed.
• Develop and maintain provider networks and fee schedules for facility and non-facility CPT codes and modifiers in the EPIC system according to reimbursement contracts.
• Develop, test, implement and maintain Epic’s Benefits Engine system to estimate patient financial responsibility and precert requirements.
• Develop, test, implement and maintain Epic Payor and Plan masterfiles to enable accurate plan selection for patient registration, benefit estimation and contract discount adjustments.
• Thoroughly document the purpose and details of all system changes.

Skills

Analytical skills

Healthcare contract analysis

Reimbursement knowledge

Education

Bachelor’s degree

Job description

Nemours is seeking a Contract Modeling Analyst to join our team. This remote role requires residing in listed states and occasional travel.

The job focuses on implementing and maintaining Epic’s Contract Reimbursement system, including contracts, networks, payors, plans, and masterfiles to ensure accurate accounts receivable estimation. You will analyze current contractual states, support negotiations, and provide analyses to facilitate rate language and final contractual terms within the