What are the responsibilities and job description for the Contract Modeling Analyst/Full Time/Hybrid position at Henry Ford Health System?
GENERAL SUMMARY:
Responsible for creating and managing facility and/or physician contract models for Henry Ford Health System entities using EPIC contract maintenance module.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
1. Responsible for building basic payer/plan-specific contract terms, including common reimbursement methodologies.
2. Achieve high level of accuracy with Epic contract models.
3. Research and resolve discrepancies between expected reimbursement and actual payments.
4. Performs reimbursement audits regularly especially for newly created contract models.
5. Proactive in identifying and analyzing issues for areas of opportunities.
6. Escalate payer contract non-compliance issues to contract administrators/consultants
EDUCATION/EXPERIENCE REQUIRED:
- Associate degree required or 2-4 years of professional experience.
- Bachelor's degree preferred.
- Requires 2-5 years of healthcare experience or related field.
- Epic certification/proficiency in Hospital Billing Expected Reimbursement Contracts required within six (6) months of hire.
- Prefer an understanding of reimbursement methodologies and concepts and common reimbursement methodologies (DRGs, per diems, fee schedules, APCs, etc.).
- Microsoft Excel required.
- Organization: Corporate Services
- Department: Managed Care Contracting
- Shift: Day Job
- Union Code: Not Applicable
