HB Certified Epic Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Design, develop, test, and sustain the Epic Resolute Hospital Billing (HB) configuration, which includes charge router rules, claims edits, and account-level workflows.

• Design and oversee the work queue structure, routing logic, and assignment rules to enhance staff efficiency and claim processing speed.

• Configure and assist with Bridges/BCB interfaces, statement processing, and remittance workflows.

• Utilize Slicer Dicer and Epic reporting tools to create ad hoc reports, monitor build performance, and pinpoint workflow interruptions.

• Collaborate with Epic PB, Cadence, and Claims teams to ensure seamless integration of HB build throughout the revenue cycle application suite.

• Apply CPT, ICD-10-CM, HCPCS, revenue codes, UB-04 requirements, and CMS billing guidelines for build and issue resolution.

• Keep abreast of payer-specific billing regulations, CMS regulatory updates, and Epic release notes that impact HB configuration and claim precision.

• Assist in coding and billing quality reviews, denial root-cause analysis, and underpayment investigations.

• Ensure HB workflows adhere to HIPAA, payer contracts, and relevant federal and state billing regulations.

• Support Epic HB go-lives, system upgrades, module implementations, and optimization initiatives.

• Convert end-user and business-owner requirements into system specifications, test scripts, and configuration needs.

• Engage in unit, integration, and regression testing; document defects, and verify resolutions.

• Maintain build documentation, SOPs, and job aids.

• Oversee change control for designated HB build items, including risk assessment and coordination with other Epic application teams.

• Act as an escalation point for HB production tickets, work queue issues, and claim edit challenges.

• Perform root-cause analysis on persistent billing errors, denial patterns, and claim rejections.

• Work closely with billing, accounts receivable, and denials staff to confirm that build modifications address operational issues.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Information Systems, Business, or a related discipline; or a comparable mix of education and progressive experience.

• Active Epic Resolute Hospital Billing (HB) certification is mandatory.

• A minimum of 3 years of hands-on experience in Epic HB build, configuration, or analysis within a live production environment.

• Proficient understanding of UB-04 claim forms, CPT, ICD-10-CM, HCPCS, and revenue codes, and their application in HB build logic.

• Proven experience in work queue design, charge router configuration, claims edits, and Bridges/BCB workflows.

• Familiarity with Slicer Dicer or equivalent Epic reporting tools for build validation and issue resolution.

• Comprehension of CMS billing guidelines, variations in payer policies, and how regulatory changes translate into system configuration updates.

• Strong analytical and troubleshooting abilities, with a talent for identifying root causes across data, workflows, and system builds.

• Excellent written and verbal communication skills; comfortable engaging directly with end users, business owners, and cross-functional Epic teams.

• Completion of regulatory/mandatory certifications as required.

• Willingness and capability to travel to client or organizational locations as necessary.

• Additional Epic certification(s) beyond HB, such as Resolute Professional Billing (PB), Cadence, or Claims/Remittance (preferred).

• Industry certifications like Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or an HFMA-aligned certification (preferred).

• Experience in supporting Epic go-lives, conversions, or optimization projects in a multi-client, consulting, or BPO/outsourced RCM setting (preferred).

• Exposure to revenue integrity, CDM build, or Epic-adjacent automation and AI-assisted coding tools (preferred).

• Experience with Lean, Six Sigma, or other continuous improvement methodologies applied to revenue cycle workflow redesign (preferred).

🏝️ Benefits

• Clear trajectory toward Senior Analyst, Team Lead, or Principal Consultant roles.

• Opportunity to cultivate extensive, marketable Epic expertise.

• Fully remote work arrangement.