Epic Application Analyst, Resolute Hospital Billing/Claims

Ensemble RCM; United States; Remote; USD 120,000 - 150,000; Full time

Job summary

Ensemble seeks an Epic Application Analyst specializing in Resolute Hospital Billing/Claims to serve as a bridge between Revenue Cycle Operations and IT. The role covers Epic build, configurations, workflow optimization, testing, and ongoing support for hospital billing workflows.

The ideal candidate will hold an active Epic Resolute Hospital Billing Administration or HB Claims Administration certification and have hands-on experience with hospital billing builds, work queues, claim generation,

Qualifications

• Current Epic Resolute Hospital Billing Certification required.
• Minimum 3 years of Epic build, support, implementation, or optimization experience.
• Hands-on experience with Epic Resolute Hospital Billing and HB Claims build/workflows.
• Experience with hospital billing workflows, work queues, claim edits, submission, troubleshooting.

Responsibilities

• Analyze, design, configure, test, and support Epic Resolute Hospital Billing/Claims functionality.
• Perform Epic build and configuration for hospital billing/workflow optimization.
• Support billing workflows, work queues, claim generation, submission, edits, and corrections.

Skills

Epic HB optimization

Billing workflow design

Education

Epic Resolute Hospital Billing Certification

Job description

Thank you for considering a career at Ensemble!

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our "Best in KLAS" Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

The Epic Application Analyst, Resolute Hospital Billing/Claims serves as the primary liaison between Revenue Cycle Operations and Information Technology for Epic Resolute Hospital Billing and Claims functionality. This role is responsible for Epic build, configuration, workflow optimization, testing, troubleshooting, and ongoing support of hospital billing and institutional claims workflows.

The ideal candidate will possess a current Epic Resolute Hospital Billing Administration or Epic Resolute Hospital Billing Claims Administration certification, with hands-on experience supporting the corresponding build and workflows. Relevant experience may include hospital billing configuration, work queues, claim generation, claim edits, submission, correction, and resolution.

Essential Responsibilities

Epic Resolute Hospital Billing/Claims Support & Optimization

• Analyze, design, configure, test, and support Epic functionality related to Resolute Hospital Billing and Claims.
• Perform Epic build and configuration supporting hospital billing and institutional claims workflows.
• Support billing workflows, work queues, claim generation, claim edits, submission, correction, and related revenue cycle processes.
• Troubleshoot billing and claims-related application issues and identify system or workflow root causes.
• Serve as a lead analyst for HB and/or HB Claims issues, enhancements, and optimization initiatives.
• Identify opportunities to improve billing performance, clean claim performance, and overall workflow efficiency.

Hospital Billing, Claims & Revenue Cycle Performance

• Partner with Revenue Cycle leadership and operational teams to optimize hospital billing and claims workflows.
• Analyze system-related causes of billing issues, claim errors, denials, and delays.
• Support work queues and edits associated with hospital billing and claims.
• Recommend Epic configuration and workflow improvements designed to increase billing accuracy and efficiency.
• Support initiatives focused on revenue cycle performance, denial reduction, and clean claim improvement.

System Build, Testing & Change Management

• Perform Resolute Hospital Billing and Claims-related Epic build and configuration following organizational change control processes.
• Gather business requirements and translate hospital billing and claims-related operational needs into Epic solutions.
• Create and maintain workflow documentation, decision documents, and build specifications.
• Participate in integrated testing, user acceptance testing, implementation, and post-production support.
• Troubleshoot application issues and coordinate resolution with IT teams and Epic resources.

Stakeholder & Client Support

• Serve as a subject matter expert for Epic Resolute Hospital Billing and/or HB Claims functionality.
• Partner with Revenue Cycle Operations, IT, and other stakeholders on hospital billing and claims-related initiatives.
• Educate operational stakeholders on Epic functionality and recommended billing and claims workflows.
• Support implementation, optimization, and performance improvement initiatives.

Required Qualifications

Current Epic Resolute Hospital Billing Administration or Epic Resolute Hospital Billing Claims Administration certification is required. Candidates must upload verification of their active certification prior to the interview or provide verification at the start of the interview.

Minimum 3 years of Epic build, support, implementation, or optimization experience.

Demonstrated hands-on experience with Epic Resolute Hospital Billing and/or HB Claims build and workflows.

Experience supporting hospital/facility billing and/or institutional claims workflows within revenue cycle operations.

Experience with hospital billing workflows, work queues, claim generation, claim edits, submission, troubleshooting, or related Resolut