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

UPMC; Pittsburgh (Allegheny County); Remote; USD 100,000 - 140,000; Full time

Job summary

UPMC is seeking a Systems Analyst – Team Lead to supervise a hospital billing claims group, focusing on Epic HB claims generation, remittance processing, and denial management.

The role is remote with responsibilities to guide a team, implement edits, coordinate regulatory updates (CCI, LCD, MUE) and Epic upgrades, and align IT initiatives with revenue cycle goals while ensuring on-time, on-budget project delivery.

Qualifications

• Seven years of total related experience, including one year as a senior or lead
• Professional knowledge of IT methods
• Proficient understanding of IT strategy and how it relates to business objectives
• Ability to supervise projects to completion on time and within budget
• Ability to make decisions or recommendations based on various types and amounts of information

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)
• 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

Skills

HB Claims Certification

Strong communication

Problem solving

Team leadership

Budget adherence

Tools

Epic UserWeb

Epic Sherlock

ServiceNow

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.

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 escalatet 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