What are the responsibilities and job description for the Senior Contract Modeling Analyst/Full Time/Hybrid Troy position at Henry Ford Health System?
Under supervision of Manager, responsible for creating and managing facility and / or physician contract models for Henry Ford Health System entities using EPIC contract modeling system. Achieve high level of accuracy with models and research and resolve discrepancies between contract models and payments from payors.
PRINCIPAL DUTIES AND RESPONSIBILITIES :
Using EPIC contract modeling software, create and maintain complete and accurate reimbursement models based on payor agreements including Medicare, Medicaid, Blue Cross, and other payors.
Perform extensive review, analysis and interpretation of contract modeling results. Research, explain and correct inconsistencies within the contract models.
Support contract negotiations using contract modeling software to evaluate and create reimbursement proposals.
Maintain collaborative relationships with Managed Care Contracting and Patient Accounting and Underpayment teams to share information regarding payor financial arrangements and contract models.
Research and understand Medicare, Medicaid and commercial payment methodologies and industry developments. Progress in knowledge of healthcare payment methodologies and contract modeling.
Provide guidance to and assist Contract Modeling Analysts.
Perform other duties as assigned
EDUCATION / EXPERIENCE REQUIRED :
- Bachelor's Degree in Finance, Accounting, Business Administration or related field.
- Requires a minimum 5-8 years professional experience in finance related field.
- Prefer 1-2 years of experience in contract modeling, healthcare billing, medical record coding, reimbursement or related field.
- Previous experience with EPIC contract modeling preferred.
- Requires strong oral and written communication skills, organizational and interpersonal skills, and analytical skills.
- Must possess an understanding of reimbursement methodologies and concepts and common reimbursement methodologies (DRGs, per diems, fee schedules, APCs, etc.).
- Microsoft Excel required and relational database experience preferred.
