Senior Financial Systems Analyst – Epic Billing Reimbursement

Baylor Scott & White Health; Richmond (VA); On-site; USD 90,000 - 115,000; Full time

Benefits offered by this job

Health benefits

401(k) matching

Tuition Reimbursement

PTO accrual from Day 1

Job summary

Baylor Scott & White Health is seeking a contract and reimbursement specialist to support managed care contracts within Epic Hospital Billing (HB) and Professional Billing (PB). The role includes monitoring contract performance and identifying underpayments to improve reimbursement.

You will translate terms, maintain payer mappings, and collaborate with Revenue Cycle, IT, and payer representatives to ensure accurate reimbursements in line with CMS/Medicare/Medicaid rules.

Qualifications

• Bachelor's degree or 4 years of relevant work experience in healthcare finance.
• 3–5 years experience in Managed Care, Government Finance, Revenue Cycle, Billing, or related fields.
• Experience with CMS or Texas Medicaid Programs is preferred.
• Experience with Epic HB/PB or any other EHR software is a plus.

Responsibilities

• Configure payer reimbursement contracts in Epic HB and PB.
• Translate managed care terms, exclusions, carve-outs, stop‑loss provisions, fee schedules, and payment methodologies.
• Develop test scenarios to ensure accurate reimbursement calculations in HB/PB.
• Research reimbursement discrepancies and collaborate with multiple teams for resolution.
• Maintain payer and plan mappings to link contracts to correct payers, plans, products, service areas and billing entities.
• Maintain build specs, testing evidence, approvals, change controls, and SOPs.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and other teams.
• Stay current on CMS, Medicare, and Medicaid reimbursement rules and regulatory updates.

Skills

Epic HB/PB knowledge

Cross-functional collaboration

Analytical thinking

Problem solving

Communication

Education

Bachelor's degree or equivalent experience

Tools

Epic HB/PB

Job description

Baylor Scott & White Health is seeking a contract and reimbursement specialist to support managed care contracts within Epic Hospital Billing (HB) and Professional Billing (PB). The role includes monitoring contract performance and identifying underpayments to improve reimbursement.

You will translate terms, maintain payer mappings, and collaborate with Revenue Cycle, IT, and payer representatives to ensure accurate reimbursements in line with CMS/Medicare/Medicaid rules.