Company :Allegheny Health Network
Job Description :
This job builds and maintains hospital, professional, and ASC contracts in Epic. Identifies underpaid accounts and articulates the source of the processing error to the payor. Partners with stakeholders within the Hospital and Physician organizations to provide analysis on payor policy changes, site of care, etc. Utilizes various methods of contract modeling in Epic to support the contract negotiation process.
- Utilizes Epic contract modeling tools to monitor contract performance for new contracts and annual rate updates. (25%)
- Manages underpayment AR for assigned payors including successfully recovering on underpaid accounts. (20%)
- Accurately, efficiently, and independently builds hospital, professional, and ASC contracts in Epic. (20%)
- Collaborates with Revenue Cycle and Finance Teams on contract building and analysis requests. (20%)
- Performs complex analyses to support reimbursement impact analysis. (15%)
- Perform other duties as assigned or required.
- Bachelor's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field OR 6 years of relevant experience in lieu of Bachelor's degree
- 1 year in finance, contracting, or data analysis
Epic Expected Reimbursement Contracts Certification
- Microsoft Office (Excel, PowerPoint, etc.)
- Ability to analyze and interpret various types of data including financial results, operational metrics, clinical outcomes, and other key datasets
- Ability to work with large quantities of detailed data and illuminate the higher-level strategic insights that can impact business operations and performance
- Ability to juggle multiple projects at once and manage time effectively, in order to meet established deadlines
- Strong oral and written communication skills
- Ability to independently make progress on key projects with support from supervisor or peer analysts
- Master's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field
- 1 year with with hospital, physician, and ASC contracts
- 1 year in healthcare
- R, Python, or other statistical/programming tools
- Knowledge of healthcare industry, particularly as it relates to hospitals or other providers reimbursement methodologies
- Clinical background or general understanding of hospital/physician practice operations
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
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