GENESIS HEALTHCARE SYSTEM

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always.
Position Details:
Work Shift:
Day Shift (United States of America)
Scheduled Weekly Hours:
40
Department:
Business Development & Strategy
Overview of Position:
Maintains accurate third party payer reimbursement modeling and contract maintenance systems. Verifies reporting from such systems in order to provide accurate, high quality information pertaining to contract management outcomes as needed for financial and other analysis Provides tracking and analysis of quality measures present in reimbursement contracts.

QUALIFICATIONS

1. Bachelor’s degree in Accounting, Business Administration, Healthcare, or related area or equivalent experience with reimbursement methodologies, contract language, and adjudication of claims.
2. Ability to read and write in order to understand, explain, or describe moderately complex information.
3. Strong verbal and written communication, problem solving and critical thinking skills.
4. Ability to independently prioritize and focus on multiple tasks concurrently.
5. Strong PC skills in Word, Excel, Lotus Notes, and Windows applications.
6. Appropriate EPIC certification to be obtained within provided timeline, if EPIC certifications are not already obtained.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Ability to operate a personal computer for 4 to 8 hours per day. Occasional prolonged standing and walking.
2. Ability to read print of various sizes.
3. Ability to work with detail and accuracy for prolonged periods.
4. Ability to utilize standard office equipment.
5. Ability to do some light lifting, stooping, and bending.
This description reflects in general terms the type and level of work performed. It is not intended to be all-inclusive, nor portray the specific duties of any one incumbent.
Thank you for your interest in employment at Genesis. Genesis is committed to being an equal opportunity employer. Selection of applicants for employment is based only on qualifications and the requirements of a specific job

1. Tracks and analyzes system performance on contract requirements such as quality scorecards
2. Completes contract modeling, performance reporting, and maintenance within Epic
3. Performs investigation and analysis of assigned work queues within Epic.
4. Assists with new payer/plan build and design within Epic.
5. Negotiates payment on individual non-network cases.
6. Assists with third party payer reimbursement communications and is the liaison to all hospital departments and outside entities that have business with the Financial & Reimbursement Services department.
7. Provides support to the Managed Care team by converting data into information.
8. Supports all hospital departments with reimbursement methodology, contract language knowledge, and proper identification of third-party payers during registration.
9. Develops and maintains documentation and procedures, as needed, to provide training to other staff.
10. Functions as primary resource dedicated to designing, building, testing, and activating the contract management information systems. These include Epic Hospital Billing and any other contract management system.
11. Responsible for resolving Epic expected reimbursement system functionality issues via assigned Footprints tickets.
12. Documents and maintains all required contract management system design, build and change documents.
13. Contributes to testing of all contract management systems to ensure proper system configuration.
14. Works with all contract management system vendors to resolve issues/problems in a timely manner.
15. Effectively utilizes project tools, technologies and methodologies to provide clear and concise documentation/communication (i.e. project tracking, weekly reports, etc.).
16. Maintains open communications with functional area manager/director regarding projects and systems issues.
17. Prioritizes and schedules projects and resources.