Revenue Cycle Contract Analyst

Job Details

Job Description

Accountable for interpretation building monitoring and analyzing Jefferson Health reimbursement levels in Experian Contract Manager to ensure accurate and complete payments in accordance with all contractual payer obligations.

with coworkers visitors and other staff consistent with the values of Jefferson.

2. Identifies tracks monitors and follows-up on underpaid and overpaid claims by contracted payers utilizing Experian/ Epic Contract Manager to maximize revenue. Re-process claims as required.

3. Monitor and maintain Experian and Epic Contract Manager software. Includes updates to taxonomy multiple procedure rules modifier tables are current and reflect current payer policy.

4. Review interpret translate and build payer contract language into Epic and Experian structure. Assist with modeling proposed payer contracts and evaluating impact to the health system.

5. Model current charge levels against newly signed contracts to ensure maximum reimbursement. Prepares reports for payment posting and performance statistics for underpayment appeals and credit balances.

6. Model and monitor future financial impact on major payor policy changes in order to utilize the no harm clause in our negotiated terms.

Experience in hospital and physician billing and follow-up coding reimbursement guidelines payer policy and health insurance; Experience with EPIC Experian Contract Manager or other Contract Management tools; Advanced Microsoft Office (excel MS Access); ability to review/interpret financial reports strong analytical and critical thinking skills strong understanding of providers revenue cycle process; strong organizational skills and ability to multi-task.

Required Experience Education Certification(s) License(s)

Education:

HS Diploma or equivalent required; Bachelors degree strongly preferred or an additional 4 years of experience in lieu of Bachelors degree; 5 years of related experience required

Work Shift

Worker Sub Type

Employee Entity

Primary Location Address

Nationally ranked Jefferson which is principally located in the greater Philadelphia region Lehigh Valley and Northeastern Pennsylvania and southern New Jersey is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65000 people strong dedicated to providing the highest-quality compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrows professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic clinical and applied research. Thomas Jefferson University home of Sidney Kimmel Medical College Jefferson College of Nursing and the Kanbar College of Design Engineering and Commerce dates back to 1824 and today comprises 10 colleges and three schools offering 200 undergraduate and graduate programs to more than 8300 students. Jefferson Health nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age race color religion creed sexual orientation gender gender identity marital status pregnancy national origin ancestry citizenship military status veteran status handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues including medical (including prescription) supplemental insurance dental vision life and AD&D insurance short- and long-term disability flexible spending accounts retirement plans tuition assistance as well as voluntary benefits which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues including those who work less than part-time(including per diemcolleagues adjunct faculty and Jeff Temps) have access to medical (including prescription) insurance.

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