Revenue Cycle Contract Analyst

Thomas Jefferson University • Philadelphia, PA

2h

About The Position

Accountable for interpretation, building, monitoring and analyzing Jefferson Health reimbursement levels in Experian Contract Manager to ensure accurate and complete payments in accordance with all contractual payer obligations. 1.Interacts with coworkers, visitors, and other staff consistent with the values of Jefferson. 2. Identifies, tracks, monitors, and follows-up on underpaid and overpaid claims by contracted payers utilizing Experian/ Epic Contract Manager to maximize revenue. Re-process claims as required. 3. Monitor and maintain Experian and Epic Contract Manager software. Includes updates to taxonomy, multiple procedure rules, modifier tables are current and reflect current payer policy. 4. Review, interpret, translate and build payer contract language into Epic and Experian structure. Assist with modeling proposed payer contracts and evaluating impact to the health system. 5. Model current charge levels against newly signed contracts to ensure maximum reimbursement. Prepares reports for payment posting and performance statistics for underpayment appeals and credit balances. 6. Model and monitor future financial impact on major payor policy changes, in order to utilize the “no harm clause” in our negotiated terms.

Requirements

• Experience in hospital and physician billing and follow-up, coding, reimbursement guidelines, payer policy and health insurance
• Experience with EPIC, Experian Contract Manager or other Contract Management tools
• Advanced Microsoft Office (excel , MS Access)
• ability to review/interpret financial reports
• strong analytical and critical thinking skills
• strong understanding of provider's revenue cycle process
• strong organizational skills and ability to multi-task
• HS Diploma or equivalent required
• Bachelor's degree strongly preferred, or an additional 4+ years of experience in lieu of Bachelor's degree
• 5+ years of related experience required

Responsibilities

• interpretation
• building
• monitoring
• analyzing Jefferson Health reimbursement levels
• Identifies, tracks, monitors, and follows-up on underpaid and overpaid claims
• Monitor and maintain Experian and Epic Contract Manager software
• Review, interpret, translate and build payer contract language into Epic and Experian structure
• Assist with modeling proposed payer contracts and evaluating impact to the health system
• Model current charge levels against newly signed contracts to ensure maximum reimbursement
• Prepares reports for payment posting and performance statistics for underpayment appeals and credit balances
• Model and monitor future financial impact on major payor policy changes

Benefits

• Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps ), have access to medical (including prescription) insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED