Immediate Hiring For Claims Processor

Enterprise Healthcare client has an immediate opening for a highly motivated HB/PB Claims Analyst to join their dynamic and growing team. Contract
20.50 - 30.50 per hour
education: Bachelors

The Epic Payors Contract Configuration Analyst is responsible for the loading, maintenance, and troubleshooting of all payor contracts for a dynamic health system. This role will perform payor contract builds ensuring quality and accuracy, manages contract build deficiencies, audits peer-created contract builds, and performs regularly scheduled quality checks and fee schedule upload maintenance.
The Epic Payors Contract Configuration Analyst collaborates with the Revenue Cycle Management team to address contract related build issues, and holds primary responsibility for the design, build, testing, validation, and ongoing support of the Epic contract management applications. The position requires deep knowledge of reimbursement methodologies of government payors, managed care commercial payors, software functionality and the revenue cycle workflows in Epic.
Interpret Contract Terms: Partner with Director of Payor Solutions Compliance and the team to review and clarify contract language.

• Epic System Configuration: Design, build, validate, and support the Epic contract build in alignment with revenue cycle workflows.
• System Design & Validation: Participate in design and advanced validation sessions to ensure accurate contract build configuration.
• Conduct structured application testing and maintain thorough documentation of results.
• Release Management: Review and test new builds and releases prior to production deployment.
• Resolve Contract Variances: Troubleshoot and correct discrepancies in contract builds to ensure accuracy and compliance.
• Track, update, and resolve contract build issues efficiently.
• Training Development: Collaborate with team during peer reviews to establish new workflows as necessary.
• Troubleshoot contract build related problems reported by Revenue Cycle Management team as end-users.
• Identify and recommend contract build enhancements to optimize performance.

• Epic Certification in Contract Management or related module(s) for hospital and professional.
• Experience: Minimum of 5 years of experience working with Epic systems, specifically in Contract management or similar roles.
• Must have the ability to analyze complex data, identify trends, and draw actionable insights to optimize contract performance.
• Must have a strong understanding of healthcare contracts, including terms, billing codes (CPT, HCPCS, MSDRG, APC, ICD-10, etc.), & government reimbursement methodologies.
• Hybrid or on-site work environment depending on organizational policy.

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Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad Digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).