Epic Systems and Contracts Analyst

Job Summary

Responsible for the technical EPIC HB contract build and modeling functions including the Hyperdrive, Text, and Data Courier environments.

Key Responsibilities:

• Responsible for design, development and testing of reports using innovative techniques, analyzing data from various sources and systems.
• Prepare accurate data analysis in order to communicate with regulatory agencies, contracted payers and internal leadership.
• Build and maintain advanced Microsoft Excel contract models in order to meet the functional needs of staff and streamline process flow.
• Recommend and implement technical solutions to assist in planning, streamlining and decision making.
• Maximize reimbursement by analyzing contract variances, new technology, denial trending, payment variance trending and regulatory changes.

MINIMUM QUALIFICATIONS:

• Bachelor’s degree in Business Management/Business Administration or Hospital Administration or related field AND Two (2) years of experience in data analysis and/or health care planning background.
• OR High school diploma AND six (6) years of experience in health care data analysis and / or health care system build background.
• EPIC Contracting Certification within in one year of hire, with certification completion within four months of formal training completion.

PREFERRED QUALIFICATIONS:

• Epic Contracts Management and System Application Build
• Strong understanding of Epic HB workflows, analytics and technology.
• Experience with business operations workflow in a healthcare environment including payor relations, admissions, billing, and accounts receivable.
• Experience with building system application packages and moving through multiple environments.
• Strong understanding of payor reimbursement methodologies (DRG, CPT,OPPS,IPPS, IRF, APC, PDPM)
• Strong understanding of payor contracts and HB revenue cycle functions for various facility types including Acute, Critical Access, Sole Community, Home Health, Hospice, Skilled Nursing, Behavioral, and Physical Therapy.
• Computer skills relevant to position including advanced Excel modeling with Visual Basic/.NET programming., Access Database Development, and SQL.

CORE DUTIES AND RESPONSIBILITIES:

• Systems Build and Integration: Build, test, implement, and maintain complex contracts within EPIC Contract Maintenance for utilization in expected reimbursement calculations across the system.
• Build complex HB rules, components, component groups, and extensions to ensure that contracts accurately calculate all lines of payor relations contracts.
• Analyze contract performance to ensure accuracy of build, and maintain updates based on changes in government regulations, regulatory code changes, and payor term updates.
• Active participation in system upgrades and enhancements, functional testing, and identifying solutions to complex contract pricing system build challenges.
• Maintain knowledge and certification on Epic technical workflows including how information is collected, maintained and reported in all key systems.
• Maintain and continually advance report writing skills within EPIC Reporting Workbench, StrataJazz, WEBI, SlicerDicer, and other systems as necessary.
• Design interactive spreadsheets including macro generation and complex formula development to simulate various reimbursement methodologies to meet the needs of PFS customers.
• Makes suggestions for problem solving and workflow enhancement as it relates to Patient Financial Services.
• Provides thorough financial and statistical analysis of data to support sound decision making as it relates to workflow and contracting outcomes.
• Collaboratively interacts with Information Technology to further enhance reporting needs of department.
• Maintain relationships with various departments such as; Patient Access, Financial Services, West Virginia United Insurance Services, Information Technology and Decision Support in order to support business needs and project collaboration.
• Business Requirements, Process Analysis and Report Writing: Develops reports independently and analyzes data for appropriate outcomes.
• Continually analyze data for missed opportunities for increased revenue.
• Provide monthly ad hoc reports to staff, management and external agencies.
• Communicate and educate regarding financial improvement analyses, denial issues and recommendations.
• Maintain current knowledge of third-party reimbursement regulations including managed care commercial payors, government programs (Medicare, Medicaid), and Medicare Advantage.