Job Description:

Implements new payer contracts and contract changes as directed. Cultivates and maintains payer relationships as well as internal customer relationships. The analyst develops and maintains departmental resources and tools and assists with payer payment management and reporting.

This is a partially remote position, requiring some in-person days. Selected candidate will be required to reside in CO or UT.

Essential Functions

• Interprets payer contract terms and payment methodologies for the creation and ongoing maintenance and programming of Epic’s financial system and Contract Management tool to ensure accurate calculation of expected payments based on negotiated contract terms at the time of billing for professional, hospital and ancillary services.
• Supports contract negotiations through review of contract language, development of new payment models, modeling of proposed contract terms and rates, making recommendations as appropriate to department management.
• Interacts with internal and external parties regarding communication / questions about rates and terms, rate structure and development and reconciliation of contract provisions and disputes.
• Responsible for the ongoing, timely maintenance of professional, hospital and ancillary provider fee schedules.
• Audit payer claims to ensure accuracy of system build and compliance with contract terms, investigating systematic payment issues identified by department analyses or communicated by leadership.

Skills

• Accountability
• Learning Quickly
• Emerging Technologies
• Workflow Design
• Communication
• Professional Etiquette
• Commercial Insurance
• Government Programs
• Teamwork
• Work Collaboratively

Qualifications

Required

• Demonstrated experience working in healthcare or managed care setting with a specific background in complex managed care and government contract modeling, building and maintenance for providers including health systems, physicians, hospital organizations and other ancillary facilities.   

• Ability to obtain Epic Resolute Hospital and Professional Billing Expected Reimbursement Contract Certifications within three months of hire date and maintain while in this role.

• Demonstrated patient accounting experience

• Demonstrated extensive experience with healthcare reimbursement methodologies (managed care and government payers).

• Strong experience with MS Excel, Epic and with modeling and managing professional provider fee schedules 

Preferred 

• Bachelor's degree in finance, business or related field from an accredited university.  Education is verified.
• Epic Resolute Hospital and Professional Billing Expected Reimbursement Contracts certification and experience.
• Experience with revenue cycle, patient accounting, third party payer contracting and/or payer contract modeling system.

Physical Requirements

• Ongoing need for employee to see and read information, labels, monitors, documents and be able to assess customer needs.
• Frequent interactions with customers that require employee to communicate as well as understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
• Expected to lift and utilize full range of movement to transport, pull, and push equipment. Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.

Location:

Peaks Regional Office

Work City:

Broomfield

Work State:

Colorado

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$33.75 - $53.16

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.