Job Summary:

In this role, you will play a crucial role in analyzing and modeling reimbursement contracts to ensure accurate and timely reimbursement for our healthcare system. As a member of our team, you will have the opportunity to utilize your strong analytical skills and knowledge of healthcare reimbursement regulations to make a significant impact on our organization. You will collaborate with clinical, financial, and IT teams to turn complex contract terms into actionable processes.

Performance Expectations:

• Analyze and model reimbursement contracts to ensure the accuracy and timeliness of reimbursement for healthcare services
• Utilize strong analytical skills to interpret complex healthcare reimbursement regulations and guidelines
• Work closely with internal teams to gather and analyze data related to reimbursement contracts
• Develop and maintain detailed financial models to track and forecast reimbursement revenue
• Review and evaluate reimbursement contract language to identify potential discrepancies to negotiate favorable terms
• Communicate findings and recommendations to management and other stakeholders
• Collaborate with the finance and revenue cycle teams to ensure accurate and consistent reimbursement processes
• Stay up to date on changes in healthcare reimbursement regulations and adapt modeling processes accordingly
• Identify and implement process improvements to increase efficiency and accuracy in reimbursement modeling
• Maintain organized and accurate documentation of reimbursement contracts and related data
• Provide support and guidance to other team members on reimbursement modeling and analysis
• Meet deadlines and prioritize tasks effectively to ensure timely completion of reimbursement projects
• Maintain and build contracts within Epic
• Will be required to follow Epic change management policies and standards
• Uphold the values and mission of Forrest Health in all aspects of the job
• Maintain confidentiality of sensitive financial and healthcare information
• All other duties assigned

Qualifications:

Education/Skills/Work Experience:

Bachelor’s Degree in Accounting, Finance or a related field and/or a minimum of 3 years’ experience in Healthcare Finance, Reimbursement or Contract modeling. Strong Knowledge of Healthcare Reimbursement Methodologies, including Medicare, Medicaid and Commercial Payers as well as methodologies (DRG, APC, Per Diem, Fee Schedule). Exceptional attention to detail, analytical thinking and problem-solving skills. Proficiency in financial modeling and data analysis using software such as Excel and preferred knowledge with Epic. Excellent communication and interpersonal skills with the ability to collaborate with cross-functional teams and present findings to Senior Leadership.

Certification/Licensure:

• Required within the first year of employment - Obtain Epic certification for Resolute Hospital Billing Expected Reimbursement Contracts Administration and Resolute Hospital Billing Charging Administration.

Mental Demands:

• Work well under pressure
• The ability to engage in deductive reasoning
• Critical thinking
• Exhibit strong attention to detail and accuracy
• The ability to work algebraic equations and general mathematical equations
• Observe and meet deadlines
• Strong oral and written communication skills

Work Location:

This position offers both in-office work and telecommuting work from home. Ample workspace will be provided by Forrest General Hospital (FGH) for office work. Appropriate telecommuting work environment includes but is not limited to:

• High speed internet service provided by the employee
• Desktop space to accommodate a laptop, two (2) monitors, keyboard, mouse and paper
• Private area/room without interruption
• Acknowledgment of FGH-issued equipment that remains the property of FGH and shall be returned undamaged in the event employment is terminated