Financial Systems Anlst 2

Baylor Scott & White Health•Remote,

About The Position

Primary responsibilities include supporting the preparation, implementation, testing, and maintenance of managed care and government reimbursement contracts within Epic Hospital Billing (HB) and Professional Biling (PB). Other tasks include the ongoing monitoring of contract performance, and identification of underpayments and revenue opportunities.

Requirements

Bachelor's or equivalent experience.
Five years of Managed Care, Government Finance, Revenue Cycle, Billing, or other related fields within a healthcare environment.
Experience with CMS or Texas Medicaid Programs.
Experience in Epic HB/PB or any other EHR software.
Business office operations/processes.
Application troubleshooting.
Managed Care contract and payer reimbursement.

Responsibilities

Configure payer reimbursement contracts in Epic Hospital Billing (HB) and Professional Billing (PB).
Translate managed care contracts, reimbursement terms, exclusions, carve-outs, stop-loss provisions, fee schedules, and payment methodologies.
Develop test scenarios to ensure accurate reimbursement calculations are loaded in Epic HB and PB contracts.
Research reimbursement discrepancies and collaborate with Managed Care, Government Finance, Revenue Cycle, Patient Financial Services, IT, and payer representatives for resolution.
Maintain payer and plan mapping to ensure contracts are connected to the correct payers, plans, products, service areas, location, and billing entities.
Maintain build specifications, testing evidence, assumptions, approvals, change controls, and standard operating procedures.
Serve as a cross-functional liaison to explain contract terms and Epic reimbursement logic to Revenue Cycle, Patient Financial Services, and other teams.
Maintain working knowledge of CMS, Medicare, and Medicaid reimbursement rules and methodologies, fee schedules, regulatory requirements, and policy updates.