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Central Valley PACE · 4 months ago

EPIC Billing and Claims Application Manager (Remote)

United States

Full-time

Remote

Mid Level

$104K/yr - $115K/yr

3+ years exp

Central Valley PACE is a healthcare organization seeking an EPIC Billing and Claims Application Manager. This role involves managing the configuration, implementation, and support of the EPIC EHR system for billing and claims processing, while overseeing a team and collaborating with various IT teams to enhance applications and support revenue cycle functions.

Hospital & Health Care

Responsibilities

Responsible for recruiting, training, supervising and completing performance evaluations for assigned team

Management oversight for projects and efforts including prioritization, resource utilization, timeline development and task completion

Maintain knowledge of assigned Epic and other professional billing and claims configuration management and act as subject matter expert on application(s) functionality

Assist and Understand system build changes in other Epic Application areas including but not limited to, Prelude, Cadence, MyChart, Interfaces, and EpicCare Ambulatory

Collaborate regularly with other applications to provide support where needed

Manage professional billing and claims request. Prioritize, track and resolve end-user support requests with a sense of urgency, problem solve escalated tasks

Manage the planning, design, development, build and/or configuration of applications and Epic’s Resolute Professional Billing applications, which include Resolute Professional Billing, Charge Router, General Ledger and other related Epic and third party applications

Review the status of projects and issues on ongoing basis with organization leadership; ensure project timelines are adhered to and implement plans of action as necessary

Work with end users to ensure that systems are used effectively and provide direction to improve efficiency

Train and implement workflows across Billing Department and front end areas for best system utilization to resolve claim and charge review errors

Analyze user requirements, develop and implement systems

Testing – Take responsibility for the integrity of billing application testing activities for assigned team to ensure quality standards are met

Monitor billing application modification requests and ensure best practices are being utilized

Coordinate activities of team and act as a source for direction, training and guidance

Support staff in their accurate determination and resolution of problems that affect users

Partner with billing management, operations and other stakeholders across the organization to identify and address operational issues related to Revenue Cycle performance

Conduct revenue cycle analysis and provides trends to billing and operations management to identify improvement opportunities, enhancement or system automation

In conjunction with billing management, coordinates Revenue Cycle system enhancements, and upgrades with IT, Operations, and other departments as needed

Conduct research and interpret regulations, and other requirements to determine charging and billing alternatives and compliance issues in conjunction with operational and billing management

Oversee updates, including but not limited to charge master, sliding fee, contracts, billing edits as new and updated regulatory and contractual requirements are identified

Run, review, interpret, analyze, and validate Revenue Cycle reports. Ensure the integrity of data provided to all areas of the revenue cycle and other areas of the organization is necessary for good decision making

Creation and Analyzation of month-end reporting to the billing and finance teams

Additional duties and responsibilities as assigned

Qualification

EPIC build experienceEPIC certificationsRevenue Cycle knowledgeHealthcare reimbursement knowledgeAnalytical skillsMicrosoft SuiteSupervisory experienceCommunication skillsInterpersonal skillsOrganizational skills

Required

Knowledge of 3rd party and governmental billing requirements/regulations

Knowledge of healthcare reimbursement and billing procedures, HCPCS, CPT and ICD-10 coding, and medical terminology

Excellent analytical, research, communication and organizational skills as well as attention to detail

Ability to analyze and interpret large amounts of data efficiently and effectively

Understanding of the Revenue Cycle in healthcare

Possesses excellent interpersonal skills and can effectively communicate with supervisors, team members and other departments

Ability to work efficiently and effectively with tight deadlines, interruptions and high-work volume

Working knowledge in operating a personal computer, and Microsoft Suite

High school diploma or equivalent

Minimum of three (3) years of EPIC build experience preferably in an ambulatory setting, FQHC preferred

The following active EPIC certifications are required: Resolute Professional Billing Administration, Charge Router, Resolute Professional Billing Claims and Electronic Remittance Administration

Epic Professional Revenue Cycle Operations Certificate due within three (3) months of hire

EPIC certification must be continuously maintained

Previous supervisory experience required

For remote work option previous work from home experience with management of a team required