Financial & Reimbursement Consultant

Genesis Healthcare System•Moline, IL

2d•Onsite

About The Position

Maintains accurate third party payer reimbursement modeling and contract maintenance systems. Verifies reporting from such systems in order to provide accurate, high quality information pertaining to contract management outcomes as needed for financial and other analysis. Provides tracking and analysis of quality measures present in reimbursement contracts.

Requirements

Bachelor’s degree in Accounting, Business Administration, Healthcare, or related area or equivalent experience with reimbursement methodologies, contract language, and adjudication of claims.
Ability to read and write in order to understand, explain, or describe moderately complex information.
Strong verbal and written communication, problem solving and critical thinking skills.
Ability to independently prioritize and focus on multiple tasks concurrently.
Strong PC skills in Word, Excel, Lotus Notes, and Windows applications.
Appropriate EPIC certification to be obtained within provided timeline, if EPIC certifications are not already obtained.

Responsibilities

Tracks and analyzes system performance on contract requirements such as quality scorecards
Completes contract modeling, performance reporting, and maintenance within Epic
Performs investigation and analysis of assigned work queues within Epic.
Assists with new payer/plan build and design within Epic.
Negotiates payment on individual non-network cases.
Assists with third party payer reimbursement communications and is the liaison to all hospital departments and outside entities that have business with the Financial & Reimbursement Services department.
Provides support to the Managed Care team by converting data into information.
Supports all hospital departments with reimbursement methodology, contract language knowledge, and proper identification of third-party payers during registration.
Develops and maintains documentation and procedures, as needed, to provide training to other staff.
Functions as primary resource dedicated to designing, building, testing, and activating the contract management information systems. These include Epic Hospital Billing and any other contract management system.
Responsible for resolving Epic expected reimbursement system functionality issues via assigned Footprints tickets.
Documents and maintains all required contract management system design, build and change documents.
Contributes to testing of all contract management systems to ensure proper system configuration.
Works with all contract management system vendors to resolve issues/problems in a timely manner.
Effectively utilizes project tools, technologies and methodologies to provide clear and concise documentation/communication (i.e. project tracking, weekly reports, etc.).
Maintains open communications with functional area manager/director regarding projects and systems issues.
Prioritizes and schedules projects and resources.