POSITION SUMMARY/RESPONSIBILITIES
The Contract Analyst is responsible for the creation, maintenance, testing and modeling of Hospital, Transplant and Professional payer contracts. Responsible for assisting with the management of multiple billing, collections, and denials work queues, as well as identification and resolution of expected payment variances created by system calculations. Responsible for assisting in the collection and management of claim volume and/or payment data to verify that contract builds, models, and negotiated agreements are optimized. Supports the Director in the identification of opportunities for improvement and resolution of identified issues.
EDUCATION/EXPERIENCE
A Bachelor’s degree in mathematics, statistics, business, healthcare administration or equivalent work experience is required. A combined minimum of (5) years’ experience in hospital, insurance or physician billing, administration, collections and/or auditing is required. Must have Epic certification in Resolute Hospital Billing Expected Reimbursement Contracts Administration, or commit to attainment of such certification within 6 months. Must have knowledge of the Texas Medicaid system (traditional and managed care), federal Medicare Advantage, transplant, commercial and health insurance exchange programs. Knowledge of Lean principles and experience implementing Lean practices is preferred. Must possess strong interpersonal and communications skills.
LICENSURE/CREDENTIALING
Managed Care certification by the Healthcare Financial Management Association is preferred.
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