Analyst-Business I

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 depth
knowledge of managed care
contract language.

Education

Minimum Required
Bachelors 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