EPIC Managed Care Contract Analyst, Remote (43464)

Job Description:

Description

Erlanger Health hires employees for telecommuting/remote positions in the following states:

AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, SC, TN, TX, VA, WI, WY

#REMOTE

Job Summary:
The Epic Managed Care Contract Analyst is a healthcare professional specializing in analyzing and managing payer contracts in the Epic system (eChart), ensuring accurate billing, optimal reimbursement, and compliance with payer policies by meticulously reviewing contract terms, identifying potential issues, and coordinating necessary adjustments within eChart configuration to optimize revenue cycle operations.

Epic Managed Care Contract Analyst responsibilities include the following:
- Thoroughly reviewing and interpreting payer contracts to identify key terms for billing codes, payment methodologies, reimbursement rates, and other contractual obligations.
- Staying updated on payer policy changes to ensure eChart contract modeling aligns with guidelines to avoid billing errors and potential compliance issues.
- Assisting payer relations with contract modeling for payer negotiations.
- Assisting underpayment / denial analyst with contract variances, denial trends, and payment discrepancies to identify areas for improvement and implement necessary adjustments within eChart to maximize reimbursement.
- Utilizing data analytics tools within eChart to monitor contract performance and identify trends.
- Collaborate with payer relations, decision support, billing staff, and revenue cycle management teams to address contract concerns, clarify billing requirements, and ensure accurate implementation within eChart.

Education:
Required:
1. High School Diploma and 9 years' experience in one or more of the following - Healthcare, Epic IT, and/or Financial Operations.
OR
2. Associate's Degree and 7 years' experience in one or more of the following - Healthcare, Epic IT, and/or Financial Operations.
OR
3. Bachelor's Degree and 5 years' experience in one or more of the following - Healthcare, Epic IT, and/or Financial Operations.

Preferred:
- N/A

Experience:
Required:
Three years' experience in Epic contract maintenance & modeling with an in-depth knowledge of Epic contract maintenance and modeling modules. Analysts must be able to analyze complex data, identify trends, and draw actionable insights to optimize contract performance. Must have a strong understanding of healthcare contracts, including payer terms, billing codes (CPT, HCPCS, MSDRG, APC, ICD-10, etc.), & reimbursement methodologies.

Preferred:
- Five years' experience in Epic contract maintenance & modeling modules.

Position Requirement(s): License/Certification/Registration
Required:
- Resolute Hospital Billing Expected Reimbursement Contracts Administration (RHB390)
- Resolute Professional Billing Reimbursement Contracts (RPB390)

Preferred:
- N/A

Department Position Summary:
The Epic Managed Care Contract Analyst is a healthcare professional specializing in analyzing and managing payer contracts in the Epic system (eChart), ensuring accurate billing, optimal reimbursement, and compliance with payer policies by meticulously reviewing contract terms, identifying potential issues, and coordinating necessary adjustments within eChart configuration to optimize revenue cycle operations.

Epic Managed Care Contract Analyst responsibilities include the following:
- Thoroughly reviewing and interpreting payer contracts to identify key terms for billing codes, payment methodologies, reimbursement rates, and other contractual obligations.
- Staying updated on payer policy changes to ensure eChart contract modeling aligns with guidelines to avoid billing errors and potential compliance issues.
- Assisting payer relations with contract modeling for payer negotiations.
- Assisting underpayment / denial analyst with contract variances, denial trends, and payment discrepancies to identify areas for improvement and implement necessary adjustments within eChart to maximize reimbursement.
- Utilizing data analytics tools within eChart to monitor contract performance and identify trends.
- Collaborate with payer relations, decision support, billing staff, and revenue cycle management teams to address contract concerns, clarify billing requirements, and ensure accurate implementation within eChart.