Claims&Remittance&Professional Billing Analyst

Job Summary: 

Claims and Remittance analysts are the primary support contact for claims and remittance. Resolute Professional Billing analysts are the primary support contact for revenue cycle/billing operations within Epic. They coordinate all issues that arise during the project for claims and remittance and must be very knowledgeable about the organization's policies, procedures, and business operations.

Essential Duties and Responsibilities: 

• Acting as the primary support for revenue cycle end-users.
• Identifying issues that arise in the revenue cycle area as well as issues that impact other application teams, and working to resolve them 
• Guiding workflow design, building and testing the system, and analyzing other technical issues associated with Epic software
• Identifying and implementing requested changes to the system
• Serving as a liaison between end users' workflow needs and Epic implementation staff
• Maintaining regular communication with Epic representatives, including participating in weekly project team meetings
• Working with Epic representatives, your organization's business community, and end users to ensure the system meets the organization's business needs in regards to the project deliverables and timeline
• Developing an understanding of operational needs to set the direction for the organization's workflows by attending site visits and other integrated sessions
• Participating in training and working with end users
• Troubleshooting problems and questions
• Reviewing the status of projects and issues on an ongoing basis with leadership
• Holding weekly communications with team members to discuss the status of deliverables, shared issues, end‐user concerns, budget, and upcoming milestones
• Maintain compliance with the organization’s confidentiality policy in accordance to the Health Insurance Portability and Accountability Act (HIPAA).
• Maintain compliance with all company policies and procedures 
• Communicate with outside third party vendor’s
• Other duties as assigned. 

Education and/or Work Experience Requirements: 

• Understanding of upstream and downstream data sources to be able to investigate the root causes of claims errors. Because most Epic applications ultimately contribute data to claims, the application coordinator should know where each piece of data on claims forms originates in Epic.
• Solid understanding of revenue cycle management or experience with billing operations
• Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
• Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices
• High school diploma or GED required
• Associate degree preferred
• Must complete the following Epic Certifications within 2 months after completion of each class: 
  • Resolute Professional Billing Claims and Electronic Remittance Administration
  • Charge Router
  • Data Courier

Physical Requirements/Working Conditions: 

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards. 
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards

• Must be able to talk, listen and speak clearly on telephone

Monday-Friday
(2) Friday/Saturday per year