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.
Short DescriptionResponsible 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.
Experience RequiredProficient 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.
Education RequirementsBS/BA in Accounting or bachelor's degree and health care experience required.
License/Certification RequirementsEpic Certification in Resolute Physician and Hospital Billing
Recommended Jobs
RN: Registered Nurse - Home Care
RN: Registered Nurse Payrates up to $75/visit! United Methodist Communities, HomeWorks, is a rapidly growing home care agency in New Jersey bringing compassionate care into the local communiti…
Linen Aide
Job Title: Aide Location: Jersey City Medical Center Department Name: Laundry & Linen Req #: 0000217448 Status: Hourly Shift: Evening Pay Range: $17.01 - $17.01 per hour Pay Trans…
FOOD SERVICE WORKER (FULL TIME)
We are hiring immediately for a full time FOOD SERVICE WORKER position. Location: Kering Cafe - 150 Totowa Road, Wayne, NJ 07470. Note: online applications accepted only. Schedule: Full ti…
Administration Assistant
Job Description Job Description Seeking an energetic, friendly, proactive Full-Time Administrative Assistant to manage daily operations at a Reform synagogue. Responsibilities include member supp…
Administrative Assistant
Position Title: Administrative Assistant Duration: 7 months contract Location: Boston, MA Hybrid role: MUST be local to Boston and able to do a 4-1 schedule Required : …
Decorative Pillow Designer
DECORATIVE/SEASONAL PILLOW DESIGNER We offer: A business casual work environment, FREE on-site gym, complimentary shuttle service from Secaucus train station, and work from home on Fridays. Heat…
Senior Data Scientist Forecasting BI
At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are…
Laundry Attendant - Hilton Garden Inn Lawrenceville
Job Description Job Description Hotel Laundry Attendant Hilton Garden Inn Lawrence Twp / Lawrenceville, NJ Summary of Position We all understand the feeling of sinking into a clean be…
X-ray Technician
Job Title: X-Ray Technician Location: Morristown, New Jersey Pay Rate: $49 $51 per hour (W-2) Schedule: Monday Friday, 3:00 PM 11:00 PM Hours per Day: 8 hours Hours per Week: …
Full Time Neurology Job Edison, NJ
This opening is in a community just 45 minutes from NYC and an hour to Philadelphia. Enjoy the best of New Jersey with beaches nearby, great schools, safe neighborhoods, and all the amenities of subur…