"Alerted.org

Overview

Job Summary

Provides analytical support related to reimbursement to all levels of the organization. Assist hospital Business Offices in working payment variances in a timely manner. Assist with month end close process for Managed Care. Works to support the system in regards to insurance master structure and maintenance. Completes assigned goals.

Responsibilities

+ Using EPIC contract modeling software, create and maintain complete and accurate reimbursement models based on payer agreements including Medicare, Medicaid, Blue Cross, and other payors.

+ Perform extensive review, analysis and interpretation of contract modeling results. Research, explain and correct inconsistencies within the contract models.

+ Support contract negotiations using contract-modeling software to evaluate and create reimbursement proposals.

+ Maintain collaborative relationships with Managed Care Contracting and Patient Accounting share information regarding payor financial arrangements and contract models.

Research and understand Medicare, Medicaid and commercial payment methodologies and industry developments. Progress in knowledge of healthcare payment methodologies and contract modeling.

Specifications

Experience

Minimum Required

+ One (1) year of experience in a related field.

Preferred/Desired

+ Previous experience in Revenue Cycle

Education

Minimum Required

+ Bachelor’s Degree in Finance, Accounting, or related field, or equivalent combination of education and experience.

Preferred/Desired

+ MBA

Training

Minimum Required

+ Expert level Excel, including using pivot table, and slicers.

Preferred/Desired

Special Skills

Minimum Required

+ Excellent communication skills and demonstrated ability to interact with multiple levels within an organization.

Preferred/Desired

Licensure

Minimum Required

Preferred/Desired

REQNUMBER: 32415