Application Analyst - Hospital Billing Contracts

Location : Remote

Department : Corporate Systems and IT Administration

Work Type : Full Time, Salaried

Shift : Shift 1 / 8 : 00 : 00 AM to 4 : 30 : 00 PM

Minimum to Midpoint Pay - Position (FL Only) This is a remote position incumbents, who reside in Florida only, may work at home.

There may be occasional situations that require work to be performed on-site at an assigned Lee Health location.

The Application Analyst - Hospital Billing Contracts responsibilities may include but are not limited to :

• Extensive knowledge of internal financial systems and continuous learning of frequent changes to payer reimbursement regulations is critical.
• Maximize reimbursement by analyzing contract variances, new technology, denial trending, payment variance trending and regulatory changes.
• Strong Excel skills to create import templates, pivot tables, vlookup queries, etc.
• Detail oriented, with proven organizational skills and the ability to effectively manage time, prioritize tasks, and see projects through to completion on deadline.
• Strong written and verbal communication skills, with the ability to convey technical information and instructions to all levels of clinical application users in a specific, clear, and concise manner.
• Strong analytical skills and knowledge in documentation and reporting, with the ability to design and execute tests, analyze system performance data, and produce substantive reports and analyses.
• Recommend and implement technical solutions to assist in planning, streamlining and decision making.
• Possesses a high level of technical, analytical and critical thinking skills in order to access various internal and government systems.

Additional Requirements :

EPIC Resolute HB Admin certification is required

Build, test, implement, and maintain complex contracts within EPIC Contract Maintenance (including system upgrades)

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.

Epic Charge Router experience

Build complex HB rules, components, component groups, and extensions to ensure that contracts accurately calculate all lines of payor relations contracts.

Analyze contract performance and reporting data (such as Epic Alexandria Report)

Provides chargemaster updates which includes updating chargemaster codes related to annual CPT updates, quarterly HCPCS updates, payor specific updates

Knowledge of 3M Core Grouper product and how it interacts with Epic Contracts

Design interactive spreadsheets including macro generation and complex formula development to simulate various reimbursement methodologies to meet the needs of CBO customers.

Maintain relationships with various departments such as; Central Billing Office, HB Revenue Integrity, in order to support business needs and project collaboration.

Maintain current knowledge of third-party reimbursement regulations including managed care commercial payors, government programs (Medicare, Medicaid), and Medicare Advantage.

Actively participates in payer reimbursement issues until adequate resolution has been reached.

Core Values include :

• Judgment : Makes wise decisions, identifies root causes, thinks strategically, and prioritizes what to do now and what can be improved later.
• Communication : Listens well, is concise and articulate in speech and writing, treats people with respect independent of their status, and maintains calm poise in stressful situations.
• Impact : Accomplishes amazing amounts of important work, colleagues can rely upon you, focuses on results, exhibits bias-to-action, and avoids analysis-paralysis.
• Innovation : Finds practical solutions to hard problems, suggests better approaches and new ideas that prove useful, and stays nimble by minimizing complexity and finding time to simplify.
• Collaboration : Understands that work cannot be accomplished solely as an individual contributor; works through others to develop holistic solutions that meet our customer needs and the goals of the organization.

Strong problem-resolution skills : with the ability to quickly diagnose problems, and develop, test, and implement appropriate and effective solutions in a timely manner.