Senior Financial Systems Analyst, Epic HB/PB & Reimbursement

Baylor Scott & White Health; Trenton (NJ); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Immediate eligibility for health and福利

401(k) match up to 5%

Tuition Reimbursement

PTO accrual beginning Day 1

Job summary

Baylor Scott & White Health is seeking a contract and reimbursement specialist to support managed care and government reimbursement contracts within Epic Hospital Billing (HB) and Professional Billing (PB).

You'll monitor contract performance, identify underpayments and revenue opportunities, and coordinate with Managed Care, Revenue Cycle, IT, and payer representatives to resolve issues and optimize reimbursements across CMS, Medicare, and Medicaid rules.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• 3–5 years of experience in Managed Care, Government Finance, Revenue Cycle, or related healthcare领域.
• Experience with CMS/Medicare/Medicaid programs is preferred.

Responsibilities

• Configure payer reimbursement contracts in Epic HB and PB.
• Translate contract terms, exclusions, carve-outs, and fee schedules for reimbursement.
• Develop test scenarios to ensure accurate reimbursement calculations loaded in HB/PB.
• Research reimbursement discrepancies and coordinate with cross-functional teams for resolution.
• Maintain payer and plan mappings to connect contracts to payers, plans, products, and billing entities.
• Maintain build specs, testing evidence, approvals, and change controls.
• Explain contract terms and Epic reimbursement logic to Revenue Cycle and other teams.
• Keep working knowledge of CMS, Medicare, and Medicaid rules and policy updates.

Skills

Epic HB/PB proficiency

Contract analysis

Education

Bachelor's degree or 4 years of work experience

Tools

Epic HB/PB

Job description

Baylor Scott & White Health is seeking a contract and reimbursement specialist to support managed care and government reimbursement contracts within Epic Hospital Billing (HB) and Professional Billing (PB).

You'll monitor contract performance, identify underpayments and revenue opportunities, and coordinate with Managed Care, Revenue Cycle, IT, and payer representatives to resolve issues and optimize reimbursements across CMS, Medicare, and Medicaid rules.