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Nordic Healthcare Group (NHG)

Senior Consultant- Epic Resolute Hospital Billing Claims Analyst

Posted 21 hours ago
5-10 years experience
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AI Summary

The consultant will evaluate and optimize Hospital Billing claims workflows, including system configuration, testing, and troubleshooting. They will also provide project leadership and mentorship to client teams regarding revenue cycle best practices and claims performance.

Make a difference. Be happy. Grow your career.

Key Responsibilities

Perform professional services for Nordic and its affiliates in alignment with the expectations of Nordic and each applicable client, including but not limited to:

  • Evaluate current-system processes and procedures with a focus on Hospital Billing claims workflows; recommend and develop system configurations and workflow modifications based on industry best practices.
  • Apply Epic Resolute HB Claims expertise to system build, claim processing workflows, claim edits, workqueues, testing, troubleshooting, and optimization efforts.
  • Analyze and resolve complex claims-related issues including claim generation, claim transmission, billing edits, denials, rejections, and remittance processing.
  • Provide project management and project leadership services in alignment with client expectations and contracted role.
  • Provide leadership guidance and mentorship to client and Nordic teammates regarding HB Claims workflows, reimbursement processes, and revenue cycle best practices.
  • Work directly with project teams, revenue cycle stakeholders, billing departments, end-users, and leadership as project needs dictate.
  • Lead and attend meetings regarding project status, claims optimization initiatives, reimbursement performance, and ongoing work-product coordination.
  • Accurately and completely document claims build decisions, testing results, workflow recommendations, work progress, issues, escalations, and other required information in accordance with Nordic and individual client requirements.
  • Support integrated testing, user acceptance testing, claims validation, reimbursement testing, and go-live support activities.
  • Additional specific duties related to the project as may be required and dictated by client.

Skills and Experience

  • Bachelor’s degree or equivalent experience required.
  • Epic Resolute Hospital Billing certification required; Resolute HB Claims certification strongly preferred.
  • 2+ years’ relevant Epic Resolute Hospital Billing experience required.
  • 5+ years’ professional experience supporting Hospital Billing and claims-related workflows strongly preferred.
  • Previous consulting experience preferred.
  • Excellent communication skills, written and verbal.
  • Proven ability to apply problem-solving and technical skills to claims processing, claim edits, denial management, and remittance workflows.
  • Demonstrated experience supporting HB Claims build, testing, troubleshooting, optimization, and reimbursement processes preferred.
  • Must demonstrate and embody Nordic’s maxims.
  • Possess a strong work ethic and treat others with respect, keep commitments, inspire the trust of others, work ethically and with integrity, and uphold organizational values.
  • Strong attention to detail and ability to manage multiple priorities while meeting customer service commitments and project timelines.
  • Demonstrated sound judgment and appropriate escalation.
  • Highly organized, able to multi-task as well as maintain intense focus on individual tasks.
  • Self-starter with ability to maintain schedule, meet deadlines, and monitor one’s own work product.
  • Highly adaptable and able to acclimate quickly to new project assignments.
  • Aptitude for mentoring and guiding others.
  • Maintain a high degree of professionalism.
  • Must be able to work independently, as well as within a team environment.

#CM-1

Nordic is an equal opportunity employer. We are committed to creating an inclusive environment for all employees and applicants. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, marital or veteran status, or any other protected status under applicable federal, state, or local laws. We encourage individuals of all backgrounds to apply, including women, minorities, individuals with disabilities, and veterans.

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