Analyst-Business I

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.

Job 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.

• Maintain Insurance master file for entire system
  
  

Experience

Minimum Required

Five or more years’ experience in

healthcare data reporting area

such as managed care or

decision support role.

Preferred/Desired

Experience in decision support or managed care. In depth

knowledge of managed care

contract language.

Education

Minimum Required

Bachelor's Degree in Finance,

Accounting, or related field, or

equivalent combination of

education and experience.

Training

Minimum Required

Expert level Excel, including

using pivot table, and slicers.

Special Skills

Minimum Required

Excellent communication skills

and demonstrated ability to

interact with multiple levels

within an organization.

Preferred/Desired: Epic Certification