Epic Contract and Reimbursement Analyst

Here, it's different. Come join us.

Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years.

Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day.

We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report.

As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties.

Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat.

That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through our doors.

A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different.

The Contract Build Analyst is responsible for building, testing, maintaining and updating payor contracts within the revenue generation system. Duties include providing support to end users through analyzing and diagnosing problems and determining a solution specific to payor policies, inpatient and outpatient billing requirements, coding guidelines, CMS Medicare reimbursement methodologies, and chargemaster components.

Department Name: Revenue Cycle
Job Status: Full time, 40 hours per week
Shift: Day shift, 8am to 4:30pm - Hybrid or Remote

• EDUCATION - High School or GED
• EXPERIENCE - Minimum of three (3) years of related experience required
• EQUIVALENCY - None
• CERTIFICATION(S) - Epic certification in primary application will be required within four months of hire. Team members will be sent to Epic for mandatory training and will be given two attempts to pass certification testing to maintain employment

POPULATION SPECIFIC CARE

• No direct patient care.

ESSENTIAL FUNCTIONS

An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.

• Collaborates with system users and other Epic professionals to evaluate, plan, design, develop, test, implement, maintain and support revenue systems; translates business needs into system design.
• Completes payor contract updates based on terms and conditions in renewal agreements; ensures documents accurately reflect negotiated terms of contracts.
• Partners with accounting and billing teams to ensure contracts are set up appropriately to accommodate revenue recognition and billing.
• Assists payor variance team in analyzing reimbursement issues.
• Maintains knowledge of payor policies, inpatient and outpatient billing requirements, coding guidelines, CMS Medicare reimbursement methodologies, and chargemaster components (HCPCS, Rev Codes, etc.)
• Communicates and disseminates information regarding related tools, reports, analyses, and data enhancements; responds to user questions/issues.
• Analyzes and diagnoses revenue system issues, identifies root cause, and solves the problem or escalates issues when outside area of responsibility or expertise.
• Addresses technical issues that occur during installation and maintenance activities; escalates as needed.
• Completes moderate to complex detailed data collection and analysis.
• Documents design, application and technical specifications as appropriate. Works with others to create support and training documents.
• Reviews documentation for upgrades and system updates.

SCOPE AND LEVEL

Guidelines: Developmental, standard, or intermediate level. Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions.

Complexity: Falls between the entry and full performance/senior level. Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices.

Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or that are without precedent are taken up with the supervisor.

Communications: Contacts with team members, clients or the public where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function.

Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review.e.}

Ability to Perform Essential Functions of the Job

PHYSICAL REQUIRMENTS

• Vision - Near: clear vision at 20 inches or less
• Weight Lifted/Force Exerted: up to 10 pounds/4.5 kilos, up to 1/3 of time
• Hearing: able to clearly hear details
• Sit: 2/3 or more of time
• Talk: able to communicate verbally
• Mental/Emotional: able to work in close proximity to others and/or in a distracting enviroment
• Mental/Emotional: able to cope with stress effectively
• Mental/Emotional: able to prioritize effectively

WORK ENVIRONMENT

• Mental/Emotional: able to tolerate ambiguity
• Mental/Emotional: able to prioritize effectively
• Mental/Emotional: may be subject to many interruptions
• Office Work Environment: Regular/frequent exposure

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.