Application System Analyst III
Job Requirements
Job Requirements TheSenior Epic Resolute Hospital Billing (HB) Analyst Level 3serves as a senior technical and operational resource responsible for thedesign, build, optimization, and support of Epic Resolute Hospital Billing workflows and applications, includingclaims management, charge capture, reimbursement configuration, and revenue cycle integrations.
This role providesadvanced build expertise, strategic workflow guidance, and operational troubleshootingto ensure Epic supports efficient revenue cycle operations, regulatory compliance, and accurate reimbursement. The analyst works closely withrevenue cycle leadership, patient financial services (PFS), HIM, compliance, and clinical departmentsto optimize billing workflows and claims processing.
The Level 3 analyst functions as asubject matter expert, leading complex implementations, mentoring junior analysts, supporting revenue cycle optimization initiatives, and ensuring alignment with Epic best practices.
Key Responsibilities
- Design, configure, and maintainEpic Resolute Hospital Billing (HB)functionality to support revenue cycle workflows.
- Leadadvanced application build and configuration, including:
- Billing rules
- Claim edits
- Charge routing
- Work queues
- Reimbursement contracts
- Payment posting configurations
- Configure and maintainclaims processing workflows, including electronic and paper claim generation.
- MaintainEpic master filesrelated to hospital billing and claims management.
Claims & Billing Operations Support- Supportend-to-end claims management processes, including claim creation, editing, submission, and remittance processing.
- Configure and optimizeclaim edits, claim forms, and payer-specific billing requirements.
- Troubleshoot issues related to:
- Claim rejections
- Clearinghouse errors
- Electronic data interchange (EDI)
- Claim scrubbers
- Collaborate with Patient Financial Services (PFS) to resolve billing and reimbursement issues.
Revenue Cycle Optimization- Identify and implementworkflow improvementsto reduce claim denials, improve clean claim rates, and accelerate reimbursement.
- Partner with operational leaders to analyzerevenue cycle performance metricsand implement system enhancements.
- Participate in revenue cycle initiatives such as:
- Denial reduction programs
- Charge capture optimization
- Regulatory compliance updates
- Epic upgrades and new functionality adoption.
Implementation & Project Leadership- Serve as atechnical leadfor Epic HB implementations, upgrades, and optimization projects.
- Leaddesign sessions and system build activitiesfor new billing workflows or regulatory requirements.
- Develop and maintainproject documentation, including build specifications, workflow diagrams, and testing scripts.
- Coordinate testing efforts including:
- Integrated testing
- User acceptance testing
- Regression testing.
Integration & Data Flow- Support interfaces and data flow between Epic and external systems including:
- Clearinghouses
- Payer systems
- Financial reporting platforms
- Collaborate with integration teams to ensure accurate837/835 transaction processing.
Troubleshooting & Support- Providetier 2 and tier 3 application supportfor revenue cycle issues.
- Investigate and resolve complex production issues related to billing, claims, and payment processing.
- Perform root cause analysis and implement system corrections or workflow improvements.
Mentorship & Knowledge Sharing- Serve as amentor to Level 1 and Level 2 analysts.
- Provide guidance on Epic build standards, troubleshooting, and best practices.
- Lead knowledge-sharing sessions and assist with analyst onboarding.
Work Experience Epic CertificationRequired: - Epic Resolute Hospital Billing (HB) Certification
Preferred: - Epic Claims Certification
- Epic Charge Router Certification
- Epic Revenue Cycle Administration Certification
ExperienceRequired: - 5+ years of Epic Resolute Hospital Billing experience
- Experience withEpic claims processing workflows
- Experience supportinghospital revenue cycle operations
Preferred: - Experience with:
- Clearinghouse integrations
- 837/835 EDI transactions
- Claim editing and denial management
- Epic upgrades and new version implementations
Technical SkillsStrong experience with Epic HB build including: Resolute Hospital Billing- Workqueues
- Billing rules
- Claim edits
- Charge router configuration
- Payment posting workflows
- Remittance processing
Claims Management- Electronic claims submission
- Claim form configuration (UB-04)
- Clearinghouse integrations
- Claim rejection and denial workflows
Revenue Cycle Knowledge- Hospital billing operations
- Reimbursement methodologies
- Managed care contracts
- Revenue integrity practices
Soft Skills- Strong analytical and problem-solving skills
- Ability to translate operational needs into technical system design
- Excellent communication and stakeholder management skills
- Ability to manage multiple projects and priorities simultaneously
- Strong documentation and organizational skills
Work Experience
Epic Certification
- Epic Resolute Hospital Billing (HB) Certification required:
Preferred: - Epic Claims Certification
- Epic Charge Router Certification
- Epic Revenue Cycle Administration Certification
Experience
Required: - 5+ years of Epic Resolute Hospital Billing experience
- Experience withEpic claims processing workflows
- Experience supportinghospital revenue cycle operations
Preferred: - Experience with:
- Clearinghouse integrations
- 837/835 EDI transactions
- Claim editing and denial management
- Epic upgrades and new version implementations
Technical Skills
Strong experience with Epic HB build including: Resolute Hospital Billing- Workqueues
- Billing rules
- Claim edits
- Charge router configuration
- Payment posting workflows
- Remittance processing
Claims Management- Electronic claims submission
- Claim form configuration (UB-04)
- Clearinghouse integrations
- Claim rejection and denial workflows
Revenue Cycle Knowledge- Hospital billing operations
- Reimbursement methodologies
- Managed care contracts
- Revenue integrity practices
Soft Skills- Strong analytical and problem-solving skills
- Ability to translate operational needs into technical system design
- Excellent communication and stakeholder management skills
- Ability to manage multiple projects and priorities simultaneously
- Strong documentation and organizational skills
Benefits
All your information will be kept confidential according to EEO guidelines. Compensation: Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.
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