Contract Model Jobs in Virginia (NOW HIRING)

Job Description:

We arecommittedto offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states:

• California, Connecticut, Hawaii, Illinois, Maine, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Virginia, Vermont, Washington.

This position is fully remote with some annual on-site team meetings when financials allow. | Schedule: Monday - Friday, 8AM - 5PM.

*Prefer candidates with Revenue Cycle knowledge, medical billing terms, Epic skills, Hospital Resolute Epic Contract Build Cert.

Essential Functions

• Interprets payer contract terms and payment methodologies for the creation and ongoing maintenance and programming of Epic's financial system and Contract Management tool to ensure accurate calculation of expected payments based on negotiated contract terms at the time of billing for professional, hospital and ancillary services.
• Supports contract negotiations through review of contract language, development of new payment models, modeling of proposed contract terms and rates, making recommendations as appropriate to department management.
• Interacts with internal and external parties regarding communication / questions about rates and terms, rate structure and development and reconciliation of contract provisions and disputes.
• Responsible for the ongoing, timely maintenance of professional, hospital and ancillary provider fee schedules.
• Audit payer claims to ensure accuracy of system build and compliance with contract terms, investigating systematic payment issues identified by department analyses or communicated by leadership.

Skills

• Accountability
• Learning Quickly
• Emerging Technologies
• Workflow Design
• Communication
• Professional Etiquette
• Commercial Insurance
• Government Programs
• Teamwork
• Work Collaboratively

Qualifications

Required

• Demonstrated experience working in healthcare or managed care setting with a specific background in complex managed care and government contract modeling, building and maintenance for providers including health systems, physicians, hospital organizations and other ancillary facilities.
• Ability to obtain Epic Resolute Hospital and Professional Billing Expected Reimbursement Contract Certifications within three months of hire date and maintain while in this role.
• Demonstrated patient accounting experience
• Demonstrated extensive experience with healthcare reimbursement methodologies (managed care and government payers).

Preferred

• Bachelor's degree in finance, business or related field from an accredited university. Education is verified.
• Epic Resolute Hospital and Professional Billing Expected Reimbursement Contracts certification and experience.
• Experience with revenue cycle, patient accounting, third party payer contracting and/or payer contract modeling system.

Physical Requirements

• Ongoing need for employee to see and read information, labels, monitors, documents and be able to assess customer needs.
• Frequent interactions with customers that require employee to communicate as well as understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
• Expected to lift and utilize full range of movement to transport, pull, and push equipment. Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.

Location:

Work City:

Work State:

Scheduled Weekly Hours:

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we usethe artificial intelligence ("AI") platform, HiredScore to improve your job application experience.HiredScore helps match your skills and experiences to the best jobs for you. WhileHiredScore assists in reviewing applications, all final decisions are made byIntermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.