Senior Consultant- Epic Resolute Hospital Billing Claims Analyst

Nordic Healthcare Group (NHG)

5d

About The Position

Nordic is seeking a Senior Consultant- Epic Resolute Hospital Billing Claims Analyst to perform professional services for Nordic and its affiliates. This role involves evaluating current-system processes and procedures with a focus on Hospital Billing claims workflows, recommending and developing system configurations and workflow modifications based on industry best practices. The analyst will apply Epic Resolute HB Claims expertise to system build, claim processing workflows, claim edits, workqueues, testing, troubleshooting, and optimization efforts. They will analyze and resolve complex claims-related issues including claim generation, claim transmission, billing edits, denials, rejections, and remittance processing. Additionally, the role includes providing project management and leadership services, guidance, and mentorship to client and Nordic teammates regarding HB Claims workflows, reimbursement processes, and revenue cycle best practices. The consultant will work directly with project teams, revenue cycle stakeholders, billing departments, end-users, and leadership, leading and attending meetings regarding project status, claims optimization initiatives, reimbursement performance, and work-product coordination. Accurate and complete documentation of claims build decisions, testing results, workflow recommendations, work progress, issues, and escalations is required. Support for integrated testing, user acceptance testing, claims validation, reimbursement testing, and go-live activities is also expected, along with additional specific duties as dictated by the client.

Requirements

• Bachelor’s degree or equivalent experience required.
• Epic Resolute Hospital Billing certification required; Resolute HB Claims certification strongly preferred.
• 2+ years’ relevant Epic Resolute Hospital Billing experience required.
• Excellent communication skills, written and verbal.
• Proven ability to apply problem-solving and technical skills to claims processing, claim edits, denial management, and remittance workflows.
• Must demonstrate and embody Nordic’s maxims.
• Possess a strong work ethic and treat others with respect, keep commitments, inspire the trust of others, work ethically and with integrity, and uphold organizational values.
• Strong attention to detail and ability to manage multiple priorities while meeting customer service commitments and project timelines.
• Demonstrated sound judgment and appropriate escalation.
• Highly organized, able to multi-task as well as maintain intense focus on individual tasks.
• Self-starter with ability to maintain schedule, meet deadlines, and monitor one’s own work product.
• Highly adaptable and able to acclimate quickly to new project assignments.
• Aptitude for mentoring and guiding others.
• Maintain a high degree of professionalism.
• Must be able to work independently, as well as within a team environment.

Nice To Haves

• 5+ years’ professional experience supporting Hospital Billing and claims-related workflows strongly preferred.
• Previous consulting experience preferred.
• Demonstrated experience supporting HB Claims build, testing, troubleshooting, optimization, and reimbursement processes preferred.

Responsibilities

• Evaluate current-system processes and procedures with a focus on Hospital Billing claims workflows; recommend and develop system configurations and workflow modifications based on industry best practices.
• Apply Epic Resolute HB Claims expertise to system build, claim processing workflows, claim edits, workqueues, testing, troubleshooting, and optimization efforts.
• Analyze and resolve complex claims-related issues including claim generation, claim transmission, billing edits, denials, rejections, and remittance processing.
• Provide project management and project leadership services in alignment with client expectations and contracted role.
• Provide leadership guidance and mentorship to client and Nordic teammates regarding HB Claims workflows, reimbursement processes, and revenue cycle best practices.
• Work directly with project teams, revenue cycle stakeholders, billing departments, end-users, and leadership as project needs dictate.
• Lead and attend meetings regarding project status, claims optimization initiatives, reimbursement performance, and ongoing work-product coordination.
• Accurately and completely document claims build decisions, testing results, workflow recommendations, work progress, issues, escalations, and other required information in accordance with Nordic and individual client requirements.
• Support integrated testing, user acceptance testing, claims validation, reimbursement testing, and go-live support activities.
• Additional specific duties related to the project as may be required and dictated by client.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior