Epic Professional Billing (PB) Claims Analyst at ClinDCast | Torre
Epic Professional Billing (PB) Claims Analyst
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ClinDCast

Epic Professional Billing (PB) Claims Analyst

ClinDCast
Posted by
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Emma
Emma
You will optimize revenue cycle performance by engineering robust Epic billing workflows.
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Full-time

Legal agreement: Contractor

Currency exchange and payroll taxes to be paid by:

Depends on the location of the candidate

Compensation USD60/hour
Negotiable
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Remote (anywhere)
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Posted 7 days ago

Requirements and responsibilities

We are seeking an experienced Epic Professional Billing (PB) Claims Analyst to support the design, configuration, optimization, and maintenance of Epic Resolute Professional Billing Claims functionality. Required Expertise: - Front-End Administration (FA). - Charge Adjustment Review. - Retroactive (Retro) processing. - Claims statements. - Single Billing Office (SBO) workflows. Strategic Partnerships: - Partner with Revenue Cycle, Patient Financial Services (PFS), Operations, and technical teams to improve billing accuracy. - Partner with Revenue Cycle, Patient Financial Services (PFS), Operations, and technical teams to improve claims processing. - Partner with Revenue Cycle, Patient Financial Services (PFS), Operations, and technical teams to improve reimbursement. - Partner with Revenue Cycle, Patient Financial Services (PFS), Operations, and technical teams to improve operational efficiency. Epic Configuration & Maintenance: - Design, configure, maintain, and optimize Epic Resolute Professional Billing (PB) Claims workflows. - Configure and support Front-End Administration (FA), billing rules, work queues, and claims processing. - Configure and maintain Claims Statement workflows and patient statement processing. - Support Single Billing Office (SBO) workflows, including billing consolidation and revenue cycle optimization. Billing & Claims Management: - Configure and troubleshoot Charge Adjustment Review. - Support Retroactive (Retro) billing updates. - Support Retroactive (Retro) adjustments. - Support Retroactive (Retro) corrections. - Configure claim edits. - Configure claim work queues. - Configure payer rules. - Configure fee schedules. - Configure provider mappings. - Configure reimbursement workflows. Claims Analysis: - Analyze and resolve claim rejections. - Analyze and resolve denials. - Analyze and resolve payment variances. - Analyze and resolve billing discrepancies. Collaboration: - Work closely with Revenue Cycle. - Work closely with Patient Financial Services (PFS). - Work closely with Health Information Management (HIM). - Work closely with Operations teams. Testing & Implementation: - Participate in system upgrades. - Participate in enhancements. - Participate in integrated testing. - Participate in regression testing. - Participate in go-live support. Documentation: - Create functional specifications. - Create build documentation. - Create workflow diagrams. - Create test scripts. Optimization & Compliance: - Monitor system performance and recommend workflow improvements to maximize clean claim rates. - Monitor system performance and recommend workflow improvements to maximize reimbursement. - Ensure compliance with HIPAA. - Ensure compliance with CMS regulations. - Ensure compliance with payer requirements. - Ensure compliance with organizational standards. Production Support: - Provide production support. - Provide issue resolution. - Provide root cause analysis. - Provide end-user training.
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