Job Summary and Responsibilities

Job Summary / Job Purpose 

Responsible for building and testing the contract modeling calculation that applies the contractual adjustment at time of billing and produces the Expected Payment within the AR/Revenue Cycle system (Meditech, PCON, Epic, PIC). This position directly impacts CHI’s financial statements as these calculations are relied upon to estimate Net AR (on CHI’s balance sheet) and is a focus of the financial audit.

Key Responsibilities

Reimbursement Calculation/Contract build/modeling – (Business critical maintenance) – Input and maintenance of Payor contracts to calculate net expected reimbursement and applies the contractual adjustment at the time of billing. For Meditech and/or PCON, Epic, PICEnsures accurate and timely maintenance of reimbursement calculation in system dictionaries and tables, based on collaboration with Payor Strategy and RRC management.Interprets managed care contracts and government reimbursement methodologies in order to correctly create the contract modeling calculation.Ensure thorough testing of all new and existing entries into the Contract Modeling/Revenue Cycle system to confirm accurate calculations for netting down AR at time of billing.Assists or works directly with other business partners as it relates to managed care contracts and government reimbursement changes that impact expected payment
Job Requirements

Job Requirements / Qualifications 

Education / Accreditation / Licensure (required & preferred): Bachelor’s Degree preferred. 
Experience (required & preferred):  Three to five years of related Revenue Cycle application experience in contract modeling and/or experience in Patient Financial Services or Finance preferred. 
Must have extensive experience and knowledge with healthcare reimbursement methodologies and concepts. 

Preferred - Hospital Billing Expected Reimbursement Contracts certification

Where You'll Work

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Total Rewards

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit our Total Rewards

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.