Managed Care Analyst - Hybrid

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs.  Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

Responsible for maintaining and updating EPIC as it relates to payor contracts rates and language.  Be the Subject Matter Expert (SME) for EPIC contract builds.

Knowledge of payor reimbursement methodologies, policies, particularly as they impact claim payment and administrative functions. 

Troubleshoot contractual issues in EPIC as it relates to incorrect claims processing. Submit Sherlock tickets requesting assistance from EPIC support to correct issues.

Update the internal departments as to the accuracy of EPIC contracts/builds. Routinely review report for inconsistencies and variances.

Engage external payer colleagues to collaborate to resolve inconsistencies, variances, also to confirm payor payment policy guidelines.

Proficient with the following business applications EPIC, Excel, Word. Ability to learn PrecisionBI/Webi.

Experience with payer/provider contracts and reimbursement. Also, should have experience in a hospital and/or physician business office environment.

Knowledge and understanding of New Jersey Medicaid and MAPS reimbursement preferred.

Must be detail oriented and have strong analytic, written and verbal communication skills.

Ability to grow and establish relationships with internal and external colleagues.

Must be able to work independently to complete assigned tasks, but also willing and able to foster a team mentality to achieve department goals and objectives.

Deadline oriented and capable of organizing multiple tasks and prioritizing as needed.

BS/BA in Accounting or bachelor's degree and health care experience required.

Epic Certification in Resolute Physician and Hospital Billing