EPIC Resolute Professional Billing Claims and Remittance - Analyst

ChristianaCare • Wilmington, DE

392d

About The Position

The EPIC Resolute Professional Billing Claims and Remittance Analyst plays a crucial role in configuring and optimizing the Epic Resolute Professional Billing module to support claims and remittance processes. This position is essential for ensuring accurate charge capture, claim submission, and remittance processing, contributing to the overall efficiency of the revenue cycle management at ChristianaCare. The role requires a blend of technical expertise and knowledge of professional billing processes, making it vital for the transition from Cerner to Epic as the electronic health record (EHR) system across the organization.

Requirements

• Bachelor's degree in Information Technology, Healthcare Administration, Health Informatics or a related field preferred.
• 2 - 3 years of experience working with Epic systems or laboratory information systems.
• Knowledge of professional billing processes, claims management, and revenue cycle management.
• High School diploma with 5 years of related experience may be considered in lieu of bachelor's degree.
• Epic Resolute Professional Billing Certification preferred for external candidates.

Nice To Haves

• EPIC certification preferred; if not certified, must become EPIC certified within 3 weeks of completing the mandatory EPIC training sessions.

Responsibilities

• Configure and optimize the Epic Resolute Professional Billing module to support claims and remittance processes.
• Ensure the system accurately captures charges, submits claims, and processes remittances.
• Manage the end-to-end claims process, including charge capture, claim submission, follow-up on outstanding claims, and denial management.
• Monitor claim submissions to ensure timely and accurate processing.
• Analyze remittance advice to ensure accurate posting of payments and adjustments.
• Identify and resolve discrepancies in billing and remittance processing.
• Develop and maintain documentation for claims and remittance workflows, system configurations, and training materials.
• Conduct training sessions for end-users, including billing staff and financial administrators, to ensure effective use of the Epic Resolute Professional Billing module.
• Provide go-live support and troubleshooting assistance to ensure a smooth transition to the new system.
• Offer ongoing support and maintenance for the Epic Resolute Professional Billing module post-implementation.
• Create and execute test scripts to validate system functionality and ensure accurate configuration.
• Assist in the development of reports and dashboards to monitor claims and remittance metrics and identify areas for improvement.
• Ensure compliance with healthcare regulatory requirements and billing standards.
• Act as a liaison between end-users and the Epic implementation team to ensure effective communication and collaboration.

Benefits

• Medical, Dental, Vision, Life Insurance
• Two retirement planning offerings, including 403(b) with company contributions
• Generous paid time off with annual roll-over and opportunities to cash out
• 12-week paid parental leave
• Tuition assistance
• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees