Application System Analyst III - Epic Resolute HB Claims (Remote)

University of Maryland Medical System; Columbia (MD); On-site; USD 59,000 - 88,000; Full time

Job summary

University of Maryland Medical System Corporation seeks a senior Epic Resolute HB Claims Analyst - Level 3 to design, build, optimize, and support Epic Resolute HB and related claims workflows. This role partners with PFS, HIM, compliance, and clinical teams to ensure compliant reimbursement and efficient revenue cycle performance.

The position leads complex initiatives, mentors teammates, and drives improvements in denials, clean claim rates, and payment posting processes.

Qualifications

• Epic Resolute Hospital Billing Claims and Remit Certification required.
• 5+ years of Epic Resolute HB Claims experience.
• Experience with hospital revenue cycle operations.

Responsibilities

• Design, configure, and maintain Epic Resolute HB functionality, including billing rules, claim edits, charge routing, workqueues, reimbursement contracts, and payment posting workflows.
• Support end-to-end claims processing, including claim creation, editing, submission, and remittance. Troubleshoot claim rejections, clearinghouse errors, EDI issues, and denial workflows.
• Identify and implement system and workflow improvements to reduce denials, improve clean claim rates, and accelerate reimbursement. Partner with operational leaders on performance initiatives.
• Lead Epic HB implementations, upgrades, and optimization efforts. Facilitate design sessions, manage build activities, and coordinate testing (integrated, UAT, regression).
• Support interfaces between Epic and external systems, including clearinghouses and payer platforms. Ensure accurate processing of 837/835 transactions.
• Provide advanced (Tier 2/3) support, perform root cause analysis, and implement long-term solutions for complex billing and claims issues.
• Mentor junior analysts, provide guidance on build standards and best practices, and lead knowledge-sharing initiatives.

Skills

Analytical thinking

Problem solving

Communication skills

Stakeholder management

Attention to detail

Education

Epic Resolute HB Certification

Tools

Epic HB

EDI interfaces

Clearinghouse systems

Job description

Position Summary

The Epic Resolute Hospital Billing (HB) Claims Analyst - Level 3 is a senior technical and operational expert responsible for the design, build, optimization, and support of Epic Resolute HB and Claims applications. This role ensures efficient revenue cycle operations, regulatory compliance, and accurate reimbursement by partnering with Patient Financial Services (PFS), HIM, compliance, and clinical teams. The analyst serves as a subject matter expert, leading complex initiatives, mentoring team members, and driving revenue cycle performance improvements.

Key Responsibilities

• System Design & Build
• Design, configure, and maintain Epic Resolute HB functionality, including billing rules, claim edits, charge routing, workqueues, reimbursement contracts, and payment posting workflows.
• Claims & Billing Operations
• Support end-to-end claims processing, including claim creation, editing, submission, and remittance. Troubleshoot claim rejections, clearinghouse errors, EDI issues, and denial workflows.
• Revenue Cycle Optimization
• Identify and implement system and workflow improvements to reduce denials, improve clean claim rates, and accelerate reimbursement. Partner with operational leaders on performance initiatives.
• Project Leadership & Implementation
• Lead Epic HB implementations, upgrades, and optimization efforts. Facilitate design sessions, manage build activities, and coordinate testing (integrated, UAT, regression).
• Integration & Data Flow
• Support interfaces between Epic and external systems, including clearinghouses and payer platforms. Ensure accurate processing of 837/835 transactions.
• Troubleshooting & Support
• Provide advanced (Tier 2/3) support, perform root cause analysis, and implement long-term solutions for complex billing and claims issues.
• Mentorship & Leadership
• Mentor junior analysts, provide guidance on build standards and best practices, and lead knowledge-sharing initiatives.

Qualifications

Work Experience

• Epic Resolute Hospital Billing Claims and Remit Certification required.
• 5+ years of Epic Resolute HB Claims experience.
• Experience with claims processing workflows and hospital revenue cycle operations.

Preferred

• Epic HB Administration, Charge Router, or Revenue Cycle Administration certifications.
• Experience with clearinghouse integrations, 837/835 EDI transactions, claim editing, denial management, and Epic upgrades.

Technical Skills

• Strong Epic HB build experience, including:
• Workqueues, billing rules, claim edits, and charge router configuration
• Payment posting and remittance processing
• Claims management expertise, including:
• Electronic claims submission and UB-04 configuration
• Clearinghouse integrations and denial workflows
• Knowledge of hospital revenue cycle operations, reimbursement methodologies, managed care contracts, Qand revenue integrity practices

Core Competencies

• Strong analytical and problem-solving skills
• Ability to translate operational needs into technical system design
• Excellent communication and stakeholder management skills
• Ability to manage multiple priorities in a fast-paced environment
• Strong documentation and organizational skills

Benefits

All your information will be kept confidential according to EEO guidelines.

Compensation

• Pay Range: $42.64 - $64.00
• Other Compensation (if applicable):
• Review the 2025-2026 UMMS Benefits Guide