The Epic Proration / Contract Epic HB Administrator is responsible for the design, configuration, maintenance, and optimization of Epic Hospital Billing (HB) contract management and reimbursement workflows. This role supports payer contract administration, expected reimbursement calculations, proration methodologies, contract modeling, and revenue cycle optimization initiatives within the Epic Resolute Hospital Billing environment.
The administrator will partner closely with Revenue Cycle, Managed Care, Contracting, Finance, and Information Technology teams to ensure payer contracts are accurately built, maintained, tested, and aligned with organizational reimbursement strategies. The ideal candidate brings deep expertise in Epic Resolute HB Administration, contract maintenance, reimbursement methodologies, and complex hospital billing workflows.

Key Responsibilities: 

• Configure, maintain, and optimize Epic Resolute Hospital Billing contract management functionality.
• Build and maintain payer contract terms, reimbursement methodologies, fee schedules, carve-outs, and contract modeling components.
• Analyze managed care agreements and translate contract language into Epic build specifications.
• Configure expected reimbursement calculations and contract-based reimbursement logic.
• Ensure accurate contract setup for Medicare, Medicaid, commercial, and specialty payer arrangements.
• Design and maintain proration methodologies supporting bundled services, split billing, and reimbursement allocation requirements.
• Validate payment distribution calculations and reimbursement allocation workflows.
• Support expected reimbursement variance analysis and payment reconciliation processes.
• Collaborate with finance and revenue integrity teams to identify reimbursement optimization opportunities.
• Investigate reimbursement discrepancies and resolve contract-related billing issues.