Remittance and PLB Applications Analyst - Nemours

Nemours is seeking a Remittance and PLB Applications Analyst (Full-Time), to join our team in Jacksonville, Florida.

This is a remote position.

This position is responsible for working with the CBO Revenue Cycle Applications Manager to provide direct support to the Central Business Office (CBO) and other Nemours affiliates by ensuring all professional and hospital electronic remittance programming functions are accurate. This includes, but is not limited to, maintaining, updating, and correcting the PB/HB Remittance setup within the Epic Hyperspace and Resolute Text applications, testing and validating all system build and new release functionality, maintaining the electronic remittance options (RMOs) and related items that pertain to remittance. This position is also responsible for ensuring other Resolute Master Files are set up to correctly support remittance and PLBs. Works with CBO representatives and leadership and other internal departments to perform reviews and analyses of workflows, data collection, report details and other technical issues associated with Epic Resolute Remittance applications.

The Remittance and PLB Applications Analyst should have the ability to recognize opportunities for process improvement and optimization activities designed to create more knowledgeable end users. The role of this position includes acting as a change agent, educator, and resource in advancing the strategic mission of Nemours.

• Assist Central Business Office associates, end users, and leadership with Remittance and PLB related issues via HelpDesk tickets and/or remittance projects with the goal of increasing prompt and accurate electronic payment posting including PLBs.
• Create and maintain Remittance Options (RMOs) for use in electronic remittance posting as well as the custom programming and rules for RMOs
• Create, maintain, monitor, and when appropriate, resolve issues in Remittance workqueues.
• Create, maintain, monitor and when appropriate, resolves issues with PLB clearing accounts
• Work with clearinghouse and other partners to ensure accurate 835 files transmission
• Work with Nemours Health Informatics and IS Departments for remittance setup, troubleshooting, and workflows.
• Work with assigned Epic Technical Support on Epic support log tickets, custom changes/fixes, Release Notes, and Epic upgrades.
• Participate in the evaluation, testing and validation of new release and upgrade functionality.
• Attends scheduled huddles and meetings to discuss team and project related activities, issues, changes, communications, and updates.
• Have the ability to work independently and meet project guidelines/timelines.
• Other duties as assigned.

Requirements:

• High School Diploma required.
• Minimum of one (5) years' experience in a healthcare related field, business office, or managed care setting required.
• Professional and/or Hospital Billing Claims and Remittance Administration EPIC Certification (or completion within 6 months of hire date).
• Understanding of the claim's revenue cycle, including but not limited to, standard billing procedures (NUCC, NUBC and ANSI), payments/denials by commercial and Medicaid health insurers.
• Able to apply critical thinking skills to building and testing of Epic applications.