Job Summary
Monitors day-to-day operations and maintenance of EPIC system to ensure system?s managed care contracts are reimbursed appropriately. Works with Revenue Cycle Vendor on issues related to enrollment of providers/Groups. Enrollment and validation of professional groups/providers and troubleshooting of issues arising from provider enrollment. Must understand Managed Care contracts and how they affect reimbursement.
Minimum Qualifications
Education:Bachelor’s degree preferred. Certified Professional Coder preferred
Experience: 5 years Professional and or Facility Billing experience required. Insurance and Government Provider enrollment preferred. 1 year EPIC Professional Billing Experience preferred.
Knowledge/Skills:Knowledge of medical terminology. Understand revenue cycle and third-party billing requirements. Ability to analyze reimbursement methodologies and propose solutions for issues identified. Significant patient accounting systems, both Professional and Facility, decision support systems, etc. knowledge and ability required, including writing, to monitor payor reimbursement and claim processing.
Contacts: Internal contact required with all practice managers and financial departments within Roper St. Francis Healthcare and their third-party Revenue Cycle Vendors. Interaction with managed care organizations and government payor representatives
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