Epic Billing & Claims Manager — Revenue Cycle Lead

Community Care Cooperative; Boston, Northern (MA, KY); Hybrid; USD 103,000 - 130,000; Full time

Job summary

Community Care Cooperative in Boston, MA is seeking a Manager, Professional Billing and Claims to lead Epic systems for professional billing, SBO, and claims for our current clients and upcoming implementations.

The role, under Community Technology Cooperative, LLC, reports to the Senior Director of Applications and collaborates with Epic and health centers to ensure workflows meet business needs, timelines, and quality standards.

Qualifications

• 5+ years Epic experience in professional billing, SBO and/or claims applications.
• Certification in Professional Billing with SBO.
• Knowledge of the revenue cycle from front end to back-end billing.
• Experience with two Epic implementations.
• Proven EMR implementation and optimization experience.

Responsibilities

• Workflow development, design, and testing for Epic applications.
• Guide workflow design, building, and testing the system, and analyzing other technical issues associated with Epic software.
• Partner with Epic representatives, the health centers' business community, and end users to ensure the system meets their business needs regarding the project deliverables and timeline.
• Engage with appropriate leadership regularly to review the status of projects and issues.
• Problem-solve concerns and escalate issues to appropriate members of the leadership team.
• Work collaboratively with the leadership team of CTC and C3 towards the strategic goals of C3, CTC and the health centers that we serve.
• Develop an understanding of operational needs to collaborate and set the direction for the organization's workflows.
• Assist with the identification, evaluation, and assessment of new technology, developing recommendations on the impact of integration with existing workflows and systems.
• Ability to manage and prioritize initiatives with competing priorities.
• Demonstrate a proactive mindset with the ability to analyze and anticipate possible events prior.
• Answer questions and foster enthusiasm for HIT projects within the health centers.
• Maintain the scope, schedule, and quality of the project in their specific application areas and/or team.
• Set clear expectations for team members, including defining what they should do at each phase of the project.
• Work closely with the program manager and other project managers to coordinate activities.
• Ensure that the health center community is informed and engaged with all aspects of the implementations and workflow.
• Advise and coach team members by providing guidance on project issues, key success factors of the project, and lessons learned.
• Develop and mentor team to build a culture of excellence, collaboration and great customer service.
• Identify and document implementation issues and best practices to create a process for future implementations.
• Share the positive effects of innovation and system capabilities with team members.
• Reinforce the importance of the project together with the executives and the project manager, and providing consistent communication to the project team.
• Appropriately matching team member skills to team responsibilities.
• Manage the project from an organizational perspective while attending to detailed tasks.
• Work directly with third-party vendor contacts for escalations and participating in monthly or quarterly check-ins.
• Maintain contracts with third party vendors, including but not limited to monitoring volumes for overage costs, reporting of total visits and users for annual renewals.
• Manage upgrades, maintenance and implementation of new features for third-party vendors.
• Other duties as assigned.

Skills

Epic experience in professionalBilling

SBO experience

Revenue cycle knowledge

EMR implementation experience

Leadership / mentoring

Job description

Community Care Cooperative in Boston, MA is seeking a Manager, Professional Billing and Claims to lead Epic systems for professional billing, SBO, and claims for our current clients and upcoming implementations.

The role, under Community Technology Cooperative, LLC, reports to the Senior Director of Applications and collaborates with Epic and health centers to ensure workflows meet business needs, timelines, and quality standards.