| Job Description | NCDHHS is a seeking an experienced Epic PB, HB and Claims Analyst. 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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