Note: The job is a remote job and is open to candidates in USA. Waterfall Technology Consulting Partners is seeking an experienced Epic Hospital Billing (HB) Analyst with expertise in HB Administration and Claims Management. The role involves end-to-end responsibility for the Epic HB applications, ensuring accurate billing and reimbursement while collaborating with various departments to enhance financial outcomes.
Responsibilities
- Analyze, design, configure, test, implement, and support Epic Hospital Billing (HB) applications
- As a top-tier SME, lead the build, maintenance, and optimization of complex reimbursement contracts and payment methodologies
- Configure and support Epic Claims and Remittance functionality, including claim generation, payment posting, and reimbursement processing
- Collaborate with patient financial services, managed care, revenue integrity, finance, and operational leaders to improve billing and reimbursement outcomes
- Translate payer contract requirements into Epic HB system configuration
- Configure and support proration methodologies and reimbursement calculations
- Troubleshoot complex billing, payment, remittance, and contract-related issues
- Perform reimbursement validation and payment variance analysis
- Lead system testing, integrated testing, upgrades, enhancements, and payer contract updates
- Develop functional specifications, workflow diagrams, and support documentation
- Identify opportunities to improve workflow efficiency, reimbursement accuracy, and revenue cycle performance
- Provide production support and ongoing optimization recommendations
- Serve as a subject matter expert for Epic HB, Claims, Remittance, Contracts, and Proration
Skills
- Epic HB certification or proficiency
- 5+ years of Epic Hospital Billing (HB) analyst experience which includes: Epic HB Administration, Claims Management, Remittance Processing, Contract Management, Proration Configuration, Reimbursement Analysis
- Bachelor's degree in Information Systems, Healthcare Administration, Business, or related field, or equivalent experience
- Extensive knowledge of hospital revenue cycle operations and payer reimbursement methodologies
- Experience building and maintaining complex payer contracts within Epic HB
- Strong analytical, troubleshooting, and problem-solving skills
- Excellent communication and stakeholder management abilities
- Epic certifications in HB, Claims, Remittance, or related revenue cycle applications
- Experience supporting large healthcare systems or integrated delivery networks
- Knowledge of managed care contracting and reimbursement modeling
- Experience with revenue integrity initiatives and denial prevention strategies
- Experience supporting Epic upgrades, implementations, and optimization projects
- Familiarity with reporting and reimbursement analytics tools
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