Contract Modeling Analyst

5 days ago

🇺🇸 United States – Remote

🐊 Florida – Remote

Although this job is listed in Florida, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Center for Health Care Strategies

WebsiteLinkedInAll Job Openings

Medicaid • Health & health care policy • Health care delivery • Payment reform • Managed long-term supports and services

51 - 200 employees

Founded 1998

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Description

• Nemours is seeking a Contract Analyst (remote) to join our Nemours Children’s Health team in Florida or Delaware. • This position is responsible for: development, implementation and maintenance of the Epic System’s Reimbursement Contracts, Provider Networks, Payor/Plans and Benefits Engine along with other Epic system-related masterfiles. • Assist in the analysis and interpretation of Managed Care Contracts in order to develop information for the Epic System that appropriately coincides with Nemours billing, coding and collection processes. • Develop, test, implement and maintain Epic reimbursement contracts including, but not limited to, rate and fee schedule adjustments, addition of CPTs and plan, provider, and component updates. • Routinely analyze EPIC system reports against contractual documentation for accuracy of setup. • Analyze available information and develop recommendations to resolve discrepancies. • Assist in the development and maintenance of Nemours’ Contract, Network, Payor and Plan Internet based insurance reference guide.

Requirements

• HS Diploma or equivalent required. • Associates degree or equivalent work experience is required. • 3 to 5 years of demonstrated strong analytical skills with knowledge of patient accounts or healthcare reimbursement. • Experience with Epic Benefits Engine and/or Epic Contract Management strongly preferred. • Hospital and/or physician billing experience from an analytical perspective strongly preferred