Managed Care Operations Analyst
2 weeks ago
At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to its employees by providing competitive rates and compensation, a comprehensive employee benefits programs, attractive working conditions, and the chance to build and explore a career opportunity by offering professional development.
Discover why Cooper University Health Care is the employer of choice in South Jersey.
Short DescriptionMaintain and update Epic and contract management tool (e.g. Strata Jazz) as it relates to contract management and maintenance, be the Subject Matter Expert (SME) for both systems as it relates to contract build.
Troubleshoot and fix Epic and contract management tool as it relates to incorrect contract logic causing claims to process incorrectly; submit help tickets requesting assistance from Epic or contract management tool to correct issues.
Update the team as to accuracy of Epic and contract management tool functionality; develop and maintain contract variance reports for contract inconsistencies.
Knowledge of payor contracting methods and reimbursement processes, particularly as they relate to claim payment and operational administrative issues.
Responsible for updating billing teams with contract documents and being the liaison between Billing and Managed Care.
Develop and maintain reporting and modeling capabilities in both Epic and contract management tool and ensuring both systems are operating at full capacity. Participate in system meetings as offered to learn about new upgrades to systems.
Run ad hoc reports and complete impact analysis as requested. Provide back up support to Business Data Analyst as assigned.
Experience RequiredProficient in Excel, Word, Access, Epic. Experience in hospital/physician business office environment, particularly in a billing or health plan administration capacity, preferred. Must have strong written and verbal communication skills and must be able to work as a team player.
Deadline oriented, having technical capability for Epic contract management maintenance; ability to work independently and in a team environment. Ability to manage multiple complex and concurrent projects.
Education RequirementsB.S. Degree in Data Analytics, Finance, or Healthcare/Business Administration preferred.
License/Certification RequirementsEpic Certification in Resolute Hospital Billing or Resolute Physician Billing.
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