Epic Resolute HB System Analyst III; Remote

Overview

The Senior Epic Resolute Hospital Billing (HB) Analyst – Level 3 serves as a senior technical and operational resource responsible for the design, build, optimization, and support of Epic Resolute Hospital Billing workflows and applications, including claims management, charge capture, reimbursement configuration, and revenue cycle integrations. This role provides advanced build expertise, strategic workflow guidance, and operational troubleshooting to ensure Epic supports efficient revenue cycle operations, regulatory compliance, and accurate reimbursement.

The analyst works closely with revenue cycle leadership, patient financial services (PFS), HIM, compliance, and clinical departments to optimize billing workflows and claims processing. The Level 3 analyst functions as a subject matter expert, leading complex implementations, mentoring junior analysts, supporting revenue cycle optimization initiatives, and ensuring alignment with Epic best practices.

• Design, configure, and maintain Epic Resolute Hospital Billing (HB) functionality to support revenue cycle workflows.
• Lead advanced application build and configuration, including:
• Billing rules
• Claim edits
• Charge routing
• Work queues
• Reimbursement contracts
• Payment posting configurations
• Configure and maintain claims processing workflows, including electronic and paper claim generation.
• Maintain Epic master files related to hospital billing and claims management.

• Support end-to-end claims management processes, including claim creation, editing, submission, and remittance processing.
• Configure and optimize claim edits, claim forms, and payer-specific billing requirements.
• Troubleshoot issues related to:
  Claim rejections, Clearinghouse errors, Electronic data interchange (EDI), Claim scrubbers.
• Collaborate with Patient Financial Services (PFS) to resolve billing and reimbursement issues.

• Identify and implement workflow improvements to reduce claim denials, improve clean claim rates, and accelerate reimbursement.
• Partner with operational leaders to analyze revenue cycle performance metrics and implement system enhancements.
• Participate in revenue cycle initiatives such as:
  Denial reduction programs, Charge capture optimization, Regulatory compliance updates, Epic upgrades and new functionality adoption.

• Serve as a technical lead for Epic HB implementations, upgrades, and optimization projects.
• Lead design sessions and system build activities for new billing workflows or regulatory requirements.
• Develop and maintain project documentation, including build specifications, workflow diagrams, and testing scripts.
• Coordinate testing efforts including:
  Integrated testing, User acceptance testing, Regression testing.

• Support interfaces and data flow between Epic and external systems including:
  Clearinghouses, Payer systems, Financial reporting platforms.
• Collaborate with integration teams to ensure accurate 837/835 transaction processing.

• Provide tier 2 and tier 3 application support for revenue cycle issues.
• Investigate and resolve complex production issues related to billing, claims, and payment processing.
• Perform root cause analysis and implement system corrections or workflow improvements.

• Serve as a mentor to Level 1 and Level 2 analysts.
• Provide guidance on Epic build standards, troubleshooting, and best practices.
• Lead knowledge-sharing sessions and assist with analyst onboarding.

• Epic Resolute Hospital Billing (HB) Certification
• 5+ years of Epic Resolute Hospital Billing experience
• Experience with Epic claims processing workflows
• Experience supporting hospital revenue cycle operations

• Epic Claims Certification
• Epic Charge Router Certification
• Epic Revenue Cycle Administration Certification
• Experience with Clearinghouse integrations
• 837/835 EDI transactions
• Claim editing and denial management
• Epic upgrades and new version implementations

• Strong Experience With Epic HB Build Including: Resolute Hospital Billing –…