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HEALTH CHOICE NETWORK

Application Analyst, PB Claims and Remittance

Posted 21 hours ago
$90000 - $105K per year
2-5 years experience
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AI Summary

The analyst is responsible for supporting, maintaining, and optimizing Epic Professional Billing workflows with a focus on claims and remittance. They will troubleshoot system issues, manage work queues, and collaborate with cross-functional teams to implement system enhancements.

Position Summary

The Epic Resolute PB Claims & Remittance Analyst is responsible for supporting, maintaining, and optimizing Epic Professional Billing workflows, with a primary focus on Claims and Remittance. This role serves as a key resource for application end-users by troubleshooting system issues, maintaining workflows, supporting system enhancements, and ensuring billing processes operate effectively and accurately.

The ideal candidate will have strong knowledge of healthcare revenue cycle operations and must hold a current Epic certification in Resolute Professional Billing (PB) Claims and Remittance.

Position Expectations

  • Serve as a primary application support contact for end-users, providing timely assistance and resolution for issues related to Epic Resolute Professional Billing Claims and Remittance.
  • Analyze and troubleshoot application, workflow, and system-related issues impacting professional billing, claims processing, and remittance.
  • Perform ongoing system maintenance, including the management and resolution of applicable work queues, error queues, claim edits, and remittance-related issues.
  • Participate in the design, build, testing, implementation, and ongoing support of Epic Professional Billing functionality.
  • Support system testing activities, including the development and execution of test scripts, validation of system changes, and coordination with key stakeholders prior to implementation.
  • Evaluate existing workflows and identify opportunities for system enhancements, automation, and process improvements.
  • Partner with Revenue Cycle, Finance, IT, operational leaders, and end-users to understand business needs and translate those needs into effective Epic solutions.
  • Assist with upgrades, enhancements, system changes, and optimization initiatives related to Professional Billing.
  • Develop and maintain appropriate system documentation, workflows, procedures, and support materials.
  • Monitor system performance and proactively identify opportunities to improve efficiency, accuracy, and the end-user experience.
  • Perform additional duties and responsibilities as assigned.

Skills and Abilities 

  • Current Epic certification in Resolute Professional Billing (PB) Claims and Remittance is required.
  • Strong knowledge and hands-on experience with Epic Resolute Professional Billing, particularly Claims and Remittance workflows.
  • Strong understanding of healthcare revenue cycle processes, including professional billing, claims submission, payment and remittance processing, denials, and claim follow-up.
  • Ability to analyze and troubleshoot complex application and workflow issues and recommend effective solutions.
  • Experience supporting Epic application configuration, maintenance, testing, upgrades, and enhancements.
  • Ability to identify opportunities for workflow optimization and recommend system solutions that align with operational and organizational needs.
  • Strong analytical, critical-thinking, and problem-solving skills.
  • Excellent written and verbal communication skills with the ability to explain technical information to non-technical audiences.
  • Strong interpersonal and active-listening skills with the ability to gather business requirements and translate them into actionable technical solutions.
  • Ability to collaborate effectively across cross-functional teams while managing multiple priorities.
  • Strong attention to detail and a commitment to accuracy, quality, and continuous improvement.

Required

  • Current Epic Resolute Professional Billing (PB) Claims and Remittance certification.
  • Experience working with Epic Resolute Professional Billing and supporting Claims and Remittance functionality.
  • Working knowledge of healthcare revenue cycle and professional billing processes.
  • Knowledge of healthcare information systems and industry best practices.

Preferred

  • Bachelor’s degree in Information Technology, Healthcare Administration, Health Informatics, Business Administration, or a related field, or an equivalent combination of education and relevant experience.
  • Experience supporting Epic applications within a healthcare, community health, population health, or similar environment.
  • Knowledge of Population Health, Community Health, and/or Public Health environments.
  • Experience collaborating with Revenue Cycle, Finance, Billing, IT, and operational teams.
  • Experience participating in Epic upgrades, implementations, optimization projects, and system enhancement initiatives.

What We Offer

At HCN, we believe in supporting our employees both professionally and personally. Our benefits include:

  • 100% Remote Work – Work from anywhere within the U.S.
  • 100% Employer-Paid Medical Insurance
  • Annual $1,500 HSA Contribution
  • Generous Paid Time Off (PTO)
  • 403(b) Retirement Plan with Employer Contribution
  • Professional Development & Education Assistance
  • Mission-Driven Culture – Be part of an organization focused on strengthening healthcare and making a meaningful impact in the communities we serv

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