Sr Reimbursement Specialist

Overview

Performing and completing day-to-day content management activities and requests from various Revenue Cycle functional stakeholders within Epic and other related information systems, including ongoing maintenance to managed care contract terms within Epic and all other related information systems. Translating written managed care contracts into system parameters that accurately reflect the contract's intent and terms during the claim adjudication process. The Sr.

Reimbursement Analyst reports to the Contract Management Manager.

This position is a highly technical and analytical role responsible for maintaining and optimizing Epic Expected Reimbursement configuration across all payer types and service lines. This role involves translating complex managed care contracts into accurate system logic to accurately reflect the intent of the negotiated terms during the claims adjudication process. It ensures payment pricing accuracy, supports Epic system maintenance and upgrades, and acts as a subject matter expert across technical and operational teams to protect revenue integrity and align with organizational financial goals.

Education

• Bachelors Degree from a recognized college/university Required or
• In Lieu of degree six (6) years of relevant work experience will be accepted in addition to the experience requirement Required

Work Experience

• 3 years of previous related healthcare Revenue Cycle or information systems experience, preferably with a focus in Epic Required or
• In lieu of degree a total of nine (9) years of experience Required
• Previous related healthcare Revenue Cycle operations, information systems, or consulting experience, preferably with a focus in Contract Management or Project Management is desired Required
• Expected Reimbursement or similar system-based configuration. Required
• Experience working within revenue cycle operations, particularly in billing, coding, AR management, or reimbursement analytics. Required
• Epic Contracts Administration Certification (Hospital and/or Professional Billing) Certification Required
• Previous related healthcare Revenue Cycle operations, information systems, or consulting experience, preferably with a focus in Contract Management or Project Management Preferred
• Prior experience using Epic strongly Preferred

• None Required

Business Unit :
Piedmont Healthcare Corporate