Contract Analyst

The Contract Analyst is responsible for the comprehensive creation, maintenance, and testing, of Hospital and Professional payer contracts. The Contract Analyst plays a crucial role as a liaison between Contracting and Revenue Cycle in the collaboration on payment data to verify that contract builds, models, and negotiated agreements are optimized. Additionally, they provide strategic support and recommendations to both teams in identifying opportunities for revenue improvement and resolving identified issues.

Development and Maintenance of Contracts: Create new and maintain existing contract fee schedules within EPIC. Collaborate with external parties for testing to ensure accuracy of contract execution. Manage ongoing updates to fee schedules for both managed care and government payers.

Ensures Reimbursement Calculations Accuracy: Responsible for ensuring that expected reimbursement calculations are current and accurate. Collaborates with Revenue Cycle to obtain billing modifier requirements and testing to ensure system calculates accurate expected reimbursement.

Support Senior Contract Analyst and Payer Contracting Team: Assist in reviewing contract set up requirements for proper contract modeling and negotiations.

Establishes and maintains favorable relationships with external customers and ensures smooth contract renewal implementations.

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelor’s degree or equivalent work experience is required.

Experience:

A combined minimum of three (3) years’ experience in healthcare or insurance billing, administration, contracting, follow up, collections and/or auditing is required in lieu of degree.

License(s):

None

Certification(s):

Must have EPIC Resolute Hospital Billing Expected Reimbursement Contracts Administration certification or commit to attainment of such certification within 6 months of hire.

Computer / Typing:

Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.