Remote Epic HB Claims Optimization Consultant

Gestão Smart Serviços Contábeis; United States; On-site; USD 118,000 - 150,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

HSA

FSA

401(k) match

Paid Time Off

Wellness Stipend

Job summary

Chartis is seeking a Business Process Consultant (BPC) with 5+ years of Epic revenue cycle leadership experience and active Epic HB Claims certifications to join our Revenue Cycle Transformation Practice in the United States. The role designs and implements solutions to improve end-to-end claims management for clients using Epic HB Claims workflows.

You will lead assessments of current processes, design future-state workflows, reduce denials, improve clean claim rates, accelerate cash flow, and

Qualifications

• 5+ years of revenue cycle leadership or consulting experience.
• Active Epic HB Claims certification required.
• Deep understanding of end-to-end revenue cycle processes, including charge capture, coding, claim edits, denial management, and A/R follow-up.
• Strong knowledge of payer rules, CMS guidelines, and regulatory requirements.

Responsibilities

• Workflow Analysis and Design: Evaluate current-state professional and hospital billing claims workflows, including charge review, claim edits, claim submission, denial management, and follow-up processes. Identify root causes of denials, compliance risks, and operational inefficiencies. Design future-state workflows aligned with Epic best practices and organizational policies.
• System Configuration and Build: Advise IT and application teams on best practices for configuring HB Claims modules, including claim edits, workqueues, routing rules, scrubbers, remittance processing, and denial workflows. When appropriate, complete in-system configuration and build to support optimized claims performance.
• Claims Performance Optimization: Analyze key revenue cycle metrics such as clean claim rate, denial rate, DNFB/DNFC, A/R days, cash acceleration, and write-offs. Develop action plans to improve claims accuracy, timeliness, and reimbursement outcomes. Leverage Epic reporting tools (Clarity, Caboodle, Reporting Workbench) to drive insights and sustainable improvements.
• Denial Prevention and Resolution Strategy: Design and implement denial prevention frameworks, including front-end and mid-cycle controls that reduce downstream claim rework. Standardize denial categorization and trending methodologies to improve root cause analysis and accountability.
• Stakeholder Collaboration: Partner closely with billing operations, coding, CDI, compliance, managed care, and IT teams. Serve as a liaison between operational and technical stakeholders by translating business needs into effective Epic system solutions.
• Optimization and Reporting: Develop and/or monitor key performance indicators (KPIs). Recommend ongoing improvements and system tweaks. Build and/or guide patient experience reporting efforts using Clarity, Caboodle, Reporting Workbench, etc.
• Testing and Validation: Guide and support testing efforts (unit, integrated, user acceptance testing, etc.). Validate new features and configurations through structured testing plans.

Skills

Revenue cycle leadership

Stakeholder collaboration

Project management

Analytical mindset

Tools

Epic HB Claims

Clarity

Caboodle

Reporting Workbench

Job description

Chartis is seeking a Business Process Consultant (BPC) with 5+ years of Epic revenue cycle leadership experience and active Epic HB Claims certifications to join our Revenue Cycle Transformation Practice in the United States. The role designs and implements solutions to improve end-to-end claims management for clients using Epic HB Claims workflows.

You will lead assessments of current processes, design future-state workflows, reduce denials, improve clean claim rates, accelerate cash flow, and