STI · 1 month ago
EPIC (Certified Resolute HB, Resolute PB Claims Analyst)
United States
Full-time
Remote
Senior Level
8+ years expSTI is seeking a Technical Specialist with expertise in HB, PB, and Claims analysis. The role involves analyzing business requirements, testing system changes, and ensuring the Epic system meets organizational needs while collaborating with various stakeholders.
Education
No H1B
Responsibilities
Analyzes, documents, and communicates business requirements for new system functionality and enhancements to existing functionality
Test system changes to ensure that they meet business requirements and do not adversely impact other areas of the Epic system
Acts as the primary support contact for the application's end-users
Identifies issues that arise in their application areas and issues that impact other application teams and works to resolve them
Guides workflow design, builds, tests the system, and analyzes other technical issues associated with Epic software
Identifies, implements, completes integrated testing, and communicates requested changes to the Epic system
Works with Epic representatives and end users to ensure the system meets the organization's business needs regarding the project deliverables and timeline
Performs in-depth analysis of current and future workflows, data collection, report details, and other technical issues associated with the Epic EHR and designated third-party applications
Partners with quality, operational, and business leaders on system design and optimization to meet quality, safety, financial, and efficiency needs
Collects requirements regarding potential system enhancements or new system implementation and prepares details of specifications needed; prioritizes and implements requested changes to the system
Investigates standardization and process improvement opportunities by rounding within revenue cycle areas while making build decisions
Validates that data is accurate and meets business requirements
Completes integrated testing to test system changes in all Epic environments to ensure that they meet business requirements and do not adversely impact other areas of the system
Troubleshoots and identifies root causes and documents problems of simple to medium complexity for assigned applications and systems
Maintains data integrity and security for assigned applications and systems
Develops system documentation as assigned per standards
Develops communication-related education efforts for deployments, upgrades, optimizations, and other system changes as assigned
Stays current on Epic application releases and participates in upgrade planning and testing
Participates in performance improvement activities to measure, assess and improve the quality of assigned work area
Qualification
Required
Must have strong leadership and communication skills with the ability to effectively present information to clinical and business leaders within the organization
Must have experience with Epic PB, HB, and Claims. 8 years required
Ability to work in small groups under tight project deadlines
Working closely with business and revenue cycle leaders around Epic workflow and to translate business needs Epic billing functionality
Must possess Epic certification, Resolute PB, HB, and Claims
Minimum of five years' progressive revenue cycle/healthcare experience with demonstrated experience in Epic build
Self-starter with demonstrated teamwork & communication skills
Excellent communication and collaboration skills
Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required
Experience working with Third Party Vendors such as Experian, Relay Health, and Hyland OnBase
Knowledge of revenue cycle billing, hospital billing, professional billing, and claims processing operations and workflows
Rapid Retest
Payer/plan creation and maintenance
PLBs
Charge Router
Contracts
Behavioral Health
Long term care psychiatric billing
CMS IPF PPS billing regulations
Substance abuse billing – IOP, methadone dosing
Medicare exhaust billing
No-pay claims
Claim splits/interim claims
Cash Management
Self-pay remittance
Developing testing scripts
Bachelor's degree or 8 years' experience in directly related field
Pass general background check
Epic module certification as assigned
Epic HB/PB Claims Certification
Company
STI
STI Education Services Group is an education administration company.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Jim Brown
TRANSPORTATION COORDINATOR
Recent News
2024-10-18
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