Systems Analyst - Team Lead (Epic HB Claims and Remittance)

UPMC; Pittsburgh (Allegheny County); Remote; USD 110,000 - 140,000; Full time

Job summary

UPMC is seeking a Systems Analyst – Team Lead to supervise a Hospital Billing Claims team with deep expertise in Epic HB claims generation, remittance processing and denial management. The role is remote and will coordinate with the Revenue Cycle IT group to ensure efficient operations.

The ideal candidate has 7+ years of related experience, Epic HB Claims and Remittance certification, and a proven track record in guiding projects to successful completion on time and within budget.

Qualifications

• 7 years of total related experience, including leadership or senior role in claims/remittance.
• Must have Epic HB Claims and Remittance certification.
• Strong problem-solving and analytical skills.
• Excellent verbal and written communication.
• Experience triaging tickets in ServiceNow or similar tool.
• Ability to enforce corporate change control policies.

Responsibilities

• Supervises a team of HB claims analysts.
• Apply corrections to CDFs, FDF/ABF and claim edits based on feedback from revenue cycle operations.
• Coordinate regulatory updates (CCI, LCD, MUE) and Epic upgrades (Nova Notes).
• Provide strong technical and functional guidance on claims and remittance administration.
• Collaborate with Professional Billing Claims team on shared projects and system issues.
• Demonstrated ability to complete projects on time and within budget.
• Make decisions based on varied information to support revenue cycle objectives.

Skills

Epic HB Claims & Remittance cert.

7+ years experience

Problem solving

Strong communication

Ticket triage tools

Change control enforcement

Epic UserWeb research

Epic Sherlock escalation

Tools

ServiceNow

Epic UserWeb

Epic Sherlock

Epic TS collaboration

Job description

UPMC is hiring a Systems Analyst – Team Lead to manage their highly accomplished Hospital Billing Claims team. Candidates with exceptional experience in Epic HB claims generation, remittance processing and denial management are encouraged to apply.

Work Location:

Remote

Responsibilities:

• Supervises a team of several HB claims analysts.
• Utilize direct feedback from revenue cycle operations to apply corrections to CDFs, FDF/ABF and claim edits.
• Coordinate Claims-owned regulatory updates and edits (CCI, LCD, MUE) as well as periodic Epic upgrades (Nova Notes)
• The position is expected to provide strong technical and functional guidance of claims and remittance administration.
• Work collaboratively with the Professional Billing Claims team on shared projects and system issues.
• Seven years of total related experience, including one year experience as a senior or lead, OR equivalent combination of education/experience. (Claims & Remittance)
• Professional knowledge of IT methods.
• Proficient understanding of IT strategy and how it relates to business objectives.
• Ability to successfully supervise projects to completion on time and within budget.
• Ability to make decisions or recommendations based on various types and amounts of information.

Top Skills Needed:

• Must have current Epic HB Claims and Remittance certification and at least 7 years of experience.
• Robust problem-solving skills. Ability to leverage Epic UserWeb for research and Epic Sherlock to elevate complex issues to Epic TS for guidance.
• Superior communication skills (verbal and written)
• Experience with ticket triaging applications (ServiceNow, or instance)
• Ability to enforce UPMC corporate change control policies

Must Have Current certification in any of the following:

• Epic HB Claims and Remittance

Licensure, Certifications, and Clearances:

Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran