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Mary Washington Healthcare · 1 month ago

EPIC Payor Reimbursement Analyst - FT - Days - Remote Optional

United States

Full-time

Remote

Mid Level

3+ years exp

Mary Washington Healthcare is seeking an EPIC Payor Reimbursement Analyst to provide analytic expertise in healthcare financial systems and managed care contracting. The role requires extensive knowledge of internal financial systems and involves analyzing contracts, monitoring contract pricing, and producing financial impact analyses.

Health CareHospital

No H1B

Responsibilities

Understanding and analysis of contracts, components, component groups, selection extensions, pricing extensions, hospital billing rules and many more items within the resolute

Interpretation and loading of multiple fee schedules used within HB contracting

Interpretation and loading multiple fee schedules used within PB contracting

Optimization of previously built contracts and creation of “new” contracts within the epic Contract Maintenance

Build contracts within Epic that reimburse by DRG, percentage of billed charges, grouper rates, case rates, global case rates, per diem and contain lesser of and stop bill language, for utilization in expected reimbursement calculations

Analyze, build, test, deploy and maintain Payor Relations contracts/fee schedules and system related functions

Monitor, analyze and test interface projects and upgrades to ensure contract pricing and language are appropriate

Utilizes contract modeling/cost accounting software to analyze/model the impact of contract rate proposals between MWHC and Payors

Maintain knowledge in technical workflow and identify/communicate trends

Analyzes and produces payor financial impact analysis for all contract proposals for HB/PB

Performs retrospective impact analysis against organization budget to ensure contractual financial results meet set financial targets

Analyzes the reimbursement impact of changes in government regulations, regulatory code changes/deletions/revisions, key managed care contracts, and third-party billing policies or requirements and reports financial impact to Manager

Utilize Excel to do the data analysis; data comes from Epic

Performance of other duties assigned

Qualification

Epic HB/PB contract buildPayor financial impact analysisHealthcare financial systemsEpic application certificationPayor reimbursement codingExcel data analysisVerbal skillsWritten skillsPresentation skillsTeamwork

Required

Minimum 3 years relevant experience

Certified in applicable Epic application and/or certified within six months of hire

Strong understanding of payor reimbursement coding (e.g., DRG, CPT, RC, HCPCS, OPPS, APC)

Strong understanding of HB/PB workflows, analytics and technology

Ability to prioritize multiple projects

Strong verbal, written and presentation skills

Ability to maintain professionalism and work within a team environment across multiple disciplines and teams

Preferred

Certified in Healthcare Financial Professional (CHFP)

Strong understanding of HB/PB revenue cycle functions and payor contracting

Strong computer skills relevant to position; extensive experience using Excel, Access Database, knowledge of Lawson and Siemen's systems and DSS/Managed Care contract modeling software