Contract Technician II

Ensemble Health Partners
3d

About The Position

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. The Opportunity: CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $51,700.00- $99,000.00/based on experience The primary role of the Contract Technician II is to support client needs relative to contract management with a minimum of 2 years Epic certification and experience. The specialist II will be responsible for support functions such as contract loading, contract validation, trouble shooting and training. The specialist II will actively participate with the Contract Management knowledge share opportunities to expand their knowledge base and role along with assisting in expanding the knowledge of their peers by assisting with training and other knowledge share opportunities. Maintain an active Epic certification in Epic Contract Management for RHB390 (acute) and/or RPB390 (physician). Conduct file balancing and daily maintenance of contract management system based on client/system need. Collaborates with Ensemble Clients to assist with inquiries related to contract accuracy and/or potential reimbursement issues. Provide support to Contract Modeling Specialists for trouble shooting (including contract review and/or Epic system navigation). Maintains 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 utilizing such tools as a Smartsheet for tracking. Uses modeling tools and reports to identify and confirm validity of payment variances for referral to the underpayments team for appeal and/or follow-up. Provide support to other revenue cycle areas regarding questions on calculations and reimbursement. Completes necessary training modules and work building sessions to become fluent in contract loading for the client host system, Epic. Provide ongoing contract validation to support client financial initiatives, including expected reimbursement based reserve calculations for budgeting purposes. Coordinates and actively participates with other associates and leaders on the team to expand and grow their knowledge of managed care organizations, contracts, and the Epic system. Knowledgeable in the interpretation of Epic product upgrade Nova Notes and completion of any needed Contract build related to them. Efficient in the import/export of Epic databases for use in reporting, troubleshooting, and other related tasks. Proficient in the use of Epic supplied Toolkits for Medicare OP and IP quarterly and annual updates.

Requirements

  • High School Diploma or GED
  • Epic RHB390 or Epic RPB390 Contract Administration Certification
  • HFMA Certified Revenue Cycle Representative
  • 2 years’ experience relative to payer reimbursement with a minimum of 2 years Epic certification in RHB390 or RPB390 Epic certification.
  • Knowledge of managed care organizations, contracts, and products or applicable healthcare or payer experience relative to position.
  • Requires a high level of problem-solving ability, initiative and judgment.
  • Requires the ability to work in a fast-paced environment balancing multiple priorities and utilizing resources aggressively.
  • Requires the ability to understand and interpret all aspects of a contract with an emphasis on the implementation and operational components of contract terms.
  • Must be a self-starter with the ability to identify, understand, research, and solve unique and complicated financial and operational provider issues as it relates to their specific contracts.
  • Microsoft Excel proficiency is recommended.
  • EPIC and/or other contract management software.
  • Excellent interpersonal skills are necessary to develop strong working relationships with internal and external contacts.

Responsibilities

  • Maintain an active Epic certification in Epic Contract Management for RHB390 (acute) and/or RPB390 (physician).
  • Conduct file balancing and daily maintenance of contract management system based on client/system need.
  • Collaborates with Ensemble Clients to assist with inquiries related to contract accuracy and/or potential reimbursement issues.
  • Provide support to Contract Modeling Specialists for trouble shooting (including contract review and/or Epic system navigation).
  • Maintains 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 utilizing such tools as a Smartsheet for tracking.
  • Uses modeling tools and reports to identify and confirm validity of payment variances for referral to the underpayments team for appeal and/or follow-up.
  • Provide support to other revenue cycle areas regarding questions on calculations and reimbursement.
  • Completes necessary training modules and work building sessions to become fluent in contract loading for the client host system, Epic.
  • Provide ongoing contract validation to support client financial initiatives, including expected reimbursement based reserve calculations for budgeting purposes.
  • Coordinates and actively participates with other associates and leaders on the team to expand and grow their knowledge of managed care organizations, contracts, and the Epic system.
  • Knowledgeable in the interpretation of Epic product upgrade Nova Notes and completion of any needed Contract build related to them.
  • Efficient in the import/export of Epic databases for use in reporting, troubleshooting, and other related tasks.
  • Proficient in the use of Epic supplied Toolkits for Medicare OP and IP quarterly and annual updates.

Benefits

  • Bonus Incentives
  • Paid Certifications
  • Tuition Reimbursement
  • Comprehensive Benefits
  • Career Advancement
  • Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
  • Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
  • Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
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