EPIC Managed Care Contract Analyst, Remote
About the position Responsibilities • 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. • Maintain and manage relationships with payer representatives and attend meetings regularly with representatives for issue resolution and data collection. • Maintain inventory of payer specific fee schedules, contract terms, and upcoming contract escalators to produce timely and accurate build / mo-ls. • Work with Erlanger Chief Officers & other executive leadership to ensure accurate Executive Dashboards, monthly general ledger reporting, and accurate service line reporting. Requirements • High School Diploma and 9 years' experience in one or more of the following: Healthcare, Epic IT, and/or Financial Operations. • OR Associate's degree and 7 years' experience in one or more of the following: Healthcare, Epic IT, and/or Financial Operations. • OR Bachelor's degree and 5 years' experience in one or more of the following: Healthcare, Epic IT, and/or Financial Operations. • Five 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. Apply tot his job
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