EPIC HB, PB, Claims Analyst [Must be certified in HB & PB Claims]

Job title: Technical Specialist- Expert (HB, PB, Claims Analyst)

Location: 3700 Wake Forest Rd, Raleigh, NC

Duration: 12 Months from projected

Interview : Either Webcam Interview or In Person

Competency Model:
Business Acumen
? Understands the organization's strategic goals and how department goals support the organization.
? Seeks opportunities to extend and deepen learning of organization and area.
? Shares new information and knowledge with others.
? Be curious; question your assumptions when presented with an issue or question.
? Self-motivated to research and learn new information and explore new options.
? Seeks to maximize potential abilities and helps others.
? Follow instructions, written or oral.
? Adhere to all scheduling and attendance requirements.
? Honesty, truthfulness, reliability, accountability
? Read, understand and apply regulations and policies.
? Knowledge of relevant privacy regulations such as The Privacy Act, Freedom of Information Act and HIPPA law
? Knowledge of revenue cycle billing, hospital billing, professional billing, and claims processing operations and workflows
? Knowledge and understanding of third-party applications.
? Establishes professional working relationships.
? Communicates verbally with team, departments, guests, and management.

Communication
? Expresses oneself clearly in conversations, business writing and interactions with others.
? Delivers oral and written communications that are impactful and persuasive to their intended audiences.
? Demonstrates a high level of emotional intelligence in the face of conflict.
? Responds to tickets and emails in a timely manner.

Planning and Organizing
? Manages and monitors time and resources effectively to complete assignments.
? Utilizes resources and gets involvement from others where appropriate.
? Shares information, materials, and time readily with others who need them

Teamwork
? Encourages participation from all team members, regardless of role within organization; supports team members and customers.
? Identifies and works through conflict that may derail the collaborative process.
? Holds self and others accountable to create unifying goals and measure with peers.
? Support NCDHHS analyst team through knowledge sharing and concise documentation.
? Applies the knowledge of fundamental IT concepts.
? Asks questions, diligently seeks and is receptive of guidance.

Drive Change
? Anticipates potential concerns/resistance to change and takes constructive steps to address them.
? Encourages others to adopt new methods or technologies that add value or improve performance.
? Keeps others focused on critical goals and deadlines through periods of change or ambiguity.
? Be flexible and adopt new processes and methods.
? Stay positive in attitude and actions.

Working Conditions:
Essential:
? May be required to work after hours or on weekends as needed
? Infrequent travel
? Pass pre-employment drug test

Experience:
? Must have strong leadership and communication skills with the ability to effectively present information to clinical and business leaders within the organization.
? Must have experience with Epic PB, HB, and Claims. 8 years required.
? Ability to work in small groups under tight project deadlines.
? Working closely with business and revenue cycle leaders around Epic workflow and to translate business needs Epic billing functionality.
? Must possess Epic certification, Resolute PB, HB, and Claims.
? Minimum of five years' progressive revenue cycle/healthcare experience with demonstrated experience in Epic build.
? Self-starter with demonstrated teamwork & communication skills.
? Excellent communication and collaboration skills.
? Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.
? Experience working with Third Party Vendors such as Experian, Relay Health, and Hyland OnBase.
? Knowledge of revenue cycle billing, hospital billing, professional billing, and claims processing operations and workflows
? Rapid Retest
? Payer/plan creation and maintenance
? PLBs
? Charge Router
? Contracts
? Behavioral Health
? Long term care psychiatric billing
? CMS IPF PPS billing regulations
? Substance abuse billing ? IOP, methadone dosing
? Medicare exhaust billing
? No-pay claims.
? Claim splits/interim claims.
? Cash Management
? Self-pay remittance
? Developing testing scripts

Responsibilities: ? Analyzes, documents, and communicates business requirements for new system functionality and enhancements to existing functionality. ? Test system changes to ensure that they meet business requirements and do not adversely impact other areas of the Epic system. ? Acts as the primary support contact for the application's end-users. ? Identifies issues that arise in their application areas and issues that impact other application teams and works to resolve them ? Guides workflow design, builds, tests the system, and analyzes other technical issues associated with Epic software ? Identifies, implements, completes integrated testing, and communicates requested changes to the Epic system ? Works with Epic representatives and end users to ensure the system meets the organization's business needs regarding the project deliverables and timeline ? Performs in-depth analysis of current and future workflows, data collection, report details, and other technical issues associated with the Epic EHR and designated third-party applications ? Partners with quality, operational, and business leaders on system design and optimization to meet quality, safety, financial, and efficiency needs ? Collects requirements regarding potential system enhancements or new system implementation and prepares details of specifications needed; prioritizes and implements requested changes to the system. ? Investigates standardization and process improvement opportunities by rounding within revenue cycle areas while making build decisions. ? Validates that data is accurate and meets business requirements. ? Completes integrated testing to test system changes in all Epic environments to ensure that they meet business requirements and do not adversely impact other areas of the system. ? Troubleshoots and identifies root causes and documents problems of simple to medium complexity for assigned applications and systems. ? Maintains data integrity and security for assigned applications and systems. ? Develops system documentation as assigned per standards. ? Develops communication-related education efforts for deployments, upgrades, optimizations, and other system changes as assigned. ? Stays current on Epic application releases and participates in upgrade planning and testing. ? Participates in performance improvement activities to measure, assess and improve the quality of assigned work area

Education:
Essential:
Bachelor's degree or 8 years' experience in directly related field

Credentials:
Essential:
? Pass general background check
? Epic module certification as assigned
? Epic HB/PB Claims Certification

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