Job Summary (List Format) for Senior Epic Resolute Hospital Billing (HB) Analyst:
- Epic Certification:
- Epic Resolute Hospital Billing (HB) Certification required
- Additional Epic certifications preferred (Claims, Contract Management, Billing Administration, Reporting Workbench, Clarity Data Model, Cogito reporting tools)
- Experience Requirements:
- 5 8+ years of healthcare IT experience
- 3 5+ years supporting Epic Resolute HB
- Experience leading Epic implementations, upgrades, and optimization projects
- Experience supporting multiple hospitals or health systems
- Demonstrated ownership of complex application builds and workflow redesigns
- Hospital Revenue Cycle Expertise:
- Strong understanding of facility, inpatient, and outpatient billing
- Claim generation and submission processes
- Reimbursement methodologies
- Revenue integrity, denials management, payment posting, credit and collections
- Knowledge of government and commercial payer requirements
- Epic Build and Support:
- Advanced configuration and maintenance of Epic Resolute HB
- Workflow analysis, optimization, and integrated testing
- Upgrade planning and testing
- Incident/problem management and change control
- End-user support and troubleshooting
- Technical Skills:
- Advanced Epic Resolute HB build skills (chargemaster integration, charge review queues, claim edits, billing rules, payment posting configuration, workqueues, remittance processing, financial class and payer setup, statement processing, account/claim workflows)
- Revenue Cycle Knowledge:
- Understanding of billing forms/regulations (UB-04, Medicare, Medicaid, commercial payers, revenue codes, DRGs, APCs, observation billing, compliance)
- Familiarity with the claims and reimbursement lifecycle
- Knowledge of revenue cycle KPIs and reporting
- Operational Workflow Knowledge:
- Familiarity with patient access, HIM coding, case management, charge capture, claims, reimbursement lifecycle
- Leadership and Collaboration:
- Lead major projects and application enhancements
- Facilitate design and workflow sessions
- Mentor junior analysts
- Coordinate testing efforts
- Serve as HB subject matter expert
- Partner with operational leadership
- Create documentation and training materials
- Recommend revenue cycle optimization strategies
- Other Requirements:
- No background check or drug screen required