Epic Real Time Eligibility Analyst

Epic Real-Time Eligibility Analyst

We are seeking an experienced Epic Real-Time Eligibility Analyst to support the integration and optimization of eligibility verification workflows within the Epic ecosystem. This individual will be responsible for configuring, maintaining, and enhancing Real-Time Eligibility (RTE) functionality, ensuring accurate patient insurance verification through integrations with Experian and other clearinghouse vendors. The ideal candidate will have strong Epic Prelude certification, hands-on RTE experience, and a deep understanding of patient access and insurance eligibility workflows.

Responsibilities:

• Configure, build, test, and support Epic Real-Time Eligibility (RTE) functionality within Epic Prelude.
• Manage eligibility data integrations between Experian and Epic.
• Ensure accurate transfer and mapping of insurance eligibility information into Epic.
• Troubleshoot eligibility verification issues and resolve interface or workflow defects.
• Collaborate with Patient Access, Revenue Cycle, Registration, and Technical teams to improve eligibility processes.
• Perform system testing, validation, and quality assurance for RTE enhancements and upgrades.
• Analyze eligibility data discrepancies and recommend workflow improvements.
• Support system optimization initiatives to improve registration accuracy and reduce claim denials.
• Create and maintain documentation related to system configurations, workflows, and testing.