Epic- Resolute Hospital Reimbursement Contract Analyst - Sarasota Memorial Health Care System

This position is responsible for clinical/business systems analysis, data management, technical support, maintenance, application and configuration, quality improvement, user support, implementation and standards and regulation of the Clinical and Business Systems throughout the organization. Responsible for all aspects of systems planning, development, and implementation including new systems, systems upgrades and enhancements. Responsible for providing analyst leadership and direction, as well as project management for small to medium sized projects. Responsible for the development and support of a stable, reliable, and customer-oriented clinical/business system and applications that meet the needs of users and the organization.

Requires Certification in Resolute Hospital Billing Expected Reimbursement Contracts. *Must be a Florida resident or relocate to Florida to become a Florida resident

• Design, build, analyze, and coordinate with key operational stakeholders to test and validate reimbursement terms.

• Collaborate with operational users to design and build the Epic system in a timely and professional manner and make corrective configuration or enhancements

• Translate user requirements into functional and technical design specifications and review with client(s) to ensure accuracy

• Should have a strong technical capacity and previous experience with reimbursement contracts.

• Mentor team members on Epic functionality as well as workflows, documentation, best practices, change management, etc.

• Serve as a subject matter expert for Epic’s Reimbursement Contracts module.

• Participate in design and validation sessions and ensure appropriate documentation, follow-up and issue escalation occurs.

• Function as a liaison between Revenue Cycle Operations, Information Technology, Managed Care, and other operational departments.

• Obtain and maintain in-depth knowledge of software functionality; acquire and utilize knowledge of operational workflows.

• Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with Epic software.

• Work with trainers to develop and maintain application specific training curriculum and materials. • Load contract language and terms in Epic.

• Research and implement new contract language, payor policies and any updated language as executed by payer and all parties.

• Translate annual contract terms into build configuration in Epic.

• Configure contracts to reflect modifier percentage changes and re-evaluate existing contractual write-offs.

• Report and follow-up on services for which the organization was underpaid or undercharged • Import fee schedules.

- Requires knowledge of the patient care setting and clinical practice, either by profession or experience.
- Require Associate Degree in Information Systems, Informatics, Business Administration, Nursing or appropriate clinical or business field. Relevant work experience may substitute on a year-for-year basis for required degree.
Require three (3) years of applicable clinical/business experience, preferably in a multi-entity health care system, large hospital, physician office, or managed care organization. Bachelor degree in a related field may substitute for up to two (2) years of required experience.

- Prefer ability to troubleshoot and document multi-system issues.
- Prefer demonstrated ability to implement test plans, create reports and train end-users.
- Prefer demonstrated ability to provide excellent customer-focused service to resolve end user production issues.
- Prefer familiarity with Microsoft Office and software packages.
- Prefer general conceptual knowledge of networks, servers and databases.
- Position may require at least one Software Certification in job area of focus.

BD: Bachelor Degree