Revenue Cycle Contract Modeling Analyst Lead

CommonSpirit Health • Chicago, IL

1d • $43 - $64

About The Position

Responsible for leading the efforts in building and testing the contract modeling calculation that applies the contractual adjustment at the time of billing and produces the Expected Payment within the AR/Revenue Cycle system (Meditech, PCON, Epic, PIC). This position provides technical guidance on complex modeling scenarios, manages related projects/tasks, and ensures the integrity of calculations, which are relied upon to estimate Net AR, a focus of the financial audit, and to identify and pursue underpayments.

Requirements

• Bachelor's degree
• 5-7 years of related experience in contract modeling and experience in Managed Care, Patient Financial Services or Finance (required).
• Must have extensive experience and knowledge with healthcare reimbursement methodologies and concepts.
• Experienced in managing technical projects and implementations.

Nice To Haves

• EPIC Certification (EPIC)

Responsibilities

• Lead the input, building, testing, and maintenance of Payor contracts to accurately calculate net expected reimbursement and apply contractual adjustments at the time of billing for Epic, Meditech, PCON, and PIC.
• Serve as the subject matter expert in interpreting complex managed care contracts and government reimbursement methodologies to correctly create and validate contract modeling calculations.
• Oversee and ensure the thorough and timely testing of all new and existing entries into the Contract Modeling/Revenue Cycle system to confirm accurate netting down of AR at the time of billing. This includes leading implementations and other expected reimbursement projects and processes.
• Proactively collaborate with Payor Strategy, RRC management, and other business partners regarding managed care contracts and government reimbursement changes that impact expected payment and system dictionaries/tables.
• Provide technical guidance and support to other team members on reimbursement calculation issues and complex contract modeling tasks.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior