Contract Modeling Analyst
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Job Location:
Englewood, CO - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Where Youll Work
Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nations largest nonprofit Catholic healthcare organizations CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2300 clinics care sites and 137 hospital-based locations in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157000 employees 45000 nurses and 25000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care community benefits and unreimbursed government programs. Together with our patients physicians partners and communities we are creating a more just equitable and innovative healthcare delivery system.
Job Summary and Responsibilities
Job Summary / Job Purpose
Responsible for building and testing the contract modeling calculation that applies the contractual adjustment at time of billing and produces the Expected Payment within the AR/Revenue Cycle system (Meditech PCON Epic PIC). This position directly impacts CHIs financial statements as these calculations are relied upon to estimate Net AR (on CHIs balance sheet) and is a focus of the financial audit.
Key Responsibilities
- Reimbursement Calculation/Contract build/modeling (Business critical maintenance) Input and maintenance of Payor contracts to calculate net expected reimbursement and applies the contractual adjustment at the time of billing. For Meditech and/or PCON Epic PIC
- Ensures accurate and timely maintenance of reimbursement calculation in system dictionaries and tables based on collaboration with Payor Strategy and RRC management.
- Interprets managed care contracts and government reimbursement methodologies in order to correctly create the contract modeling calculation.
- Ensure thorough testing of all new and existing entries into the Contract Modeling/Revenue Cycle system to confirm accurate calculations for netting down AR at time of billing.
- Assists or works directly with other business partners as it relates to managed care contracts and government reimbursement changes that impact expected payment
Job Requirements
Job Requirements / Qualifications
Education / Accreditation / Licensure (required & preferred): Bachelors Degree preferred.
Experience (required & preferred): Three to five years of related Revenue Cycle application experience in contract modeling and/or experience in Patient Financial Services or Finance preferred.
Must have extensive experience and knowledge with healthcare reimbursement methodologies and concepts.
Preferred - Hospital Billing Expected Reimbursement Contracts certification
Required Experience:
IC
Key Skills
- IVR
- SOAP
- Avaya
- Solaris
- Cost Accounting Standards
- Database Design
- Hibernate
- ITIL
- Weblogic
- Express.js
- Contracts
- ASP
About Company
Dignity Health provides compassionate, high-quality, affordable health care services throughout Arizona, California and Nevada. Schedule an appointment today!
