Epic Reimbursement Contracts Specialist (FT- 1.0 FTE, Day Shift, Remote)

Bozeman Health is hiring an Epic Reimbursement Contracts Specialist to build and maintain Hospital Billing and Professional Billing expected reimbursement contracts in Epic. The role analyzes reimbursement variances, supports underpayment appeals, and identifies payer and service-line trends to improve contract accuracy.

Responsibilities

• Design, build, analyze, test, and provide support for Epic’s Reimbursement Contracts
• Serve as the subject matter expert for Epic’s HB & PB Reimbursement Contracts modules
• Provide support to other revenue cycle areas regarding questions on calculations and reimbursement generated by the contract builds
• Liaise with IT and operations on Epic functionality, workflows, documentation, best practices, and change management
• Perform regular system audits to determine contract accuracy in HB & PB expected reimbursements
• Identify and reconcile all payment variances discovered during various audits conducted at Bozeman Health
• Maintain a schedule of key update dates for expected reimbursement rules, such as Medicare OP quarterly updates, yearly Diagnostic Related Group (DRG) updates, and yearly increases for the Managed Care contracts
• Communicate with payers and maintain up-to-date HB & PB contract inventory and payer-plan master files
• Coordinate and actively participate with other associates and leaders on the team to expand and grow their knowledge of contract reimbursement models
• Other related duties and responsibilities as assigned

Preferred

• preferably in a multi-entity health care system, large hospital, physical office, or managed care organization
• Demonstrate sound judgment, patience, and maintain a professional demeanor at all times
• Exercise tact, discretion, sensitivity, and maintains confidentiality
• Perform essential job functions successfully in a fast-paced environment
• Learn current and new computer applications and office equipment utilized at Bozeman Health
• Strong interpersonal, verbal, and written communication skills
• Analyze, organize, and prioritize work while meeting multiple deadlines
• Demonstrate the Bozeman Health SPIRIT values of: Service, People, Integrity, Respect, Improvement, and Teamwork
• Healthcare System Experience
• Large Hospital Experience
• Managed Care Experience
• Computer Application Proficiency
• Office Equipment Proficiency
• Sound Judgment
• Patience
• Professional Demeanor
• Tact
• Discretion
• Sensitivity
• Interpersonal Communication
• Verbal Communication
• Written Communication
• Analytical Skills
• Organization
• Prioritization
• Deadline Management
• Adaptability
• Service Orientation
• Integrity
• Respect
• Continuous Improvement
• Teamwork

Benefits

• This position can be remote in the approved states: Arizona, Florida, Georgia, Idaho, Iowa, South Dakota, Texas, South Carolina, Wisconsin, North Carolina, and Michigan. If your state is not listed, you must relocate to Montana or one of the approved states above to be eligible for this position.

Company

• Integrated health care delivery system serving Southwest Montana.
• Bozeman, Montana, USA
• https://www.bozemanhealth.org/
• Founded in 1911
• 1001-5000 employees

Qualifications

• Bachelor's degree in Information Systems, Informatics, Business Administration or related field; equivalent combination of education and experience may be considered
• Epic certification in Hospital Billing and Professional Billing Expected Reimbursement Contracts Administration or ability to obtain within six (6) months of hire
• Three (3) years of direct experience working on Epic Contracts Reimbursements Hospital Billing/Professional Billing including but not limited to ability to translate payer contracts into Epic system specifications using contract build tools, understanding of medical terminology, claims billing, and both inpatient and outpatient coding, ability to utilize Epic reporting tools including Alexandria Report, Contract Variance Reports, and SlicerDicer to perform in-depth underpayment analysis and identify underpayment patterns and payer trends
• five (5) years of experience in applicable clinical/business experience
• Five (5) years of experience in applicable clinical/business experience
• Preferably in a multi-entity health care system, large hospital, physical office, or managed care organization
• Demonstrate sound judgment, patience, and maintain a professional demeanor at all times
• Exercise tact, discretion, sensitivity, and maintains confidentiality
• Perform essential job functions successfully in a fast-paced environment
• Learn current and new computer applications and office equipment utilized at Bozeman Health
• Strong interpersonal, verbal, and written communication skills
• Analyze, organize, and prioritize work while meeting multiple deadlines
• Demonstrate the Bozeman Health SPIRIT values of: Service, People, Integrity, Respect, Improvement, and Teamwork

Required skills

• Claims billing, Epic Alexandria Report, Epic Contract Variance Reports, Epic SlicerDicer, Healthcare reimbursement analysis, Inpatient and outpatient coding, Payer contract translation and configuration, Underpayment analysis

Experience

• 3+ years