Certified EPIC Professional Billing [PB] Analyst

Job Title: Certified EPIC Professional Billing [PB] Analyst

Location: Raleigh, NC/REMOTE

Duration: 6+ Months

Description:

The State of North Carolina Dept. of Health and Human Services is looking for a Professional Billing Analyst to assist with the Epic EHR Implementation.

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. 5 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

• 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 and Relay Health

• Knowledge of revenue cycle 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 5 years' experience in directly related field

Credentials:

Essential:

* Pass general background check

* Resolute Professional Billing and Electronic Remittance Administration (Epic)

Resolute Professional Billing Administration (Epic)