Technical Specialist- Expert HB PB Claims Analyst

Title

Technical Specialist Expert (HB PB Claims Analyst)

Location

Remote

Duration

5 Months

Interview Type

Webcam Interview Only

Job Type

C2CW2

Job Description

NCDHHS is a seeking an experienced Epic PB HB and Claims Analyst.

Competency Model : Business Acumen

Business Acumen

• Understands the organizations strategic goals and how department goals support the organization.
• Seeks opportunities to extend and deepen learning of organization and area.
• Shares new information and knowledge with others.
• Be curious; question your assumptions when presented with an issue or question.
• Selfmotivated to research and learn new information and explore new options.
• Seeks to maximize potential abilities and helps others.
• Follow instructions written or oral.
• Adhere to all scheduling and attendance requirements.
• Honesty truthfulness reliability accountability
• Read understand and apply regulations and policies.
• Knowledge of relevant privacy regulations such as The Privacy Act Freedom of Information Act and HIPPA law
• Knowledge of revenue cycle billing hospital billing professional billing and claims processing operations and workflows
• Knowledge and understanding of thirdparty applications.
• Establishes professional working relationships.
• Communicates verbally with team departments guests and management.

Communication

• Expresses oneself clearly in conversations business writing and interactions with others.
• Delivers oral and written communications that are impactful and persuasive to their intended audiences.
• Demonstrates a high level of emotional intelligence in the face of conflict.
• Responds to tickets and emails in a timely manner.

Planning and Organizing

• Manages and monitors time and resources effectively to complete assignments.
• Utilizes resources and gets involvement from others where appropriate.
• Shares information materials and time readily with others who need them

Teamwork

• Encourages participation from all team members regardless of role within organization; supports team members and customers.
• Identifies and works through conflict that may derail the collaborative process.
• Holds self and others accountable to create unifying goals and measure with peers.
• Support NCDHHS analyst team through knowledge sharing and concise documentation.
• Applies the knowledge of fundamental IT concepts.
• Asks questions diligently seeks and is receptive of guidance.

Drive Change

• Anticipates potential concerns / resistance to change and takes constructive steps to address them.
• Encourages others to adopt new methods or technologies that add value or improve performance.
• Keeps others focused on critical goals and deadlines through periods of change or ambiguity.
• Be flexible and adopt new processes and methods.
• Stay positive in attitude and actions.

Working Conditions : Essential :

Essential :

• May be required to work after hours or on weekends as needed
• Infrequent travel
• Pass preemployment drug test

Experience :

• Must have strong leadership and communication skills with the ability to effectively present information to clinical and business leaders within the organization.
• Must have experience with Epic PB HB and Claims. 8 years required.
• Ability to work in small groups under tight project deadlines.
• Working closely with business and revenue cycle leaders around Epic workflow and to translate business needs Epic billing functionality.
• Must possess Epic certification Resolute PB HB and Claims.
• Minimum of five years progressive revenue cycle / healthcare experience with demonstrated experience in Epic build.
• Selfstarter with demonstrated teamwork & communication skills.
• Excellent communication and collaboration skills.
• Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.
• Experience working with Third Party Vendors such as Experian Relay Health and Hyland OnBase.
• Knowledge of revenue cycle billing hospital billing professional billing and claims processing operations and workflows
• Rapid Retest
• Payer / plan creation and maintenance
• PLBs
• Charge Router
• Contracts
• Behavioral Health
• Long term care psychiatric billing
• CMS IPF PPS billing regulations
• Substance abuse billing IOP methadone dosing
• Medicare exhaust billing
• Nopay claims.
• Claim splits / interim claims.
• Cash Management
• Selfpay remittance
• Developing testing scripts

Responsibilities :

• Analyzes documents and communicates business requirements for new system functionality and enhancements to existing functionality.
• Test system changes to ensure that they meet business requirements and do not adversely impact other areas of the Epic system.
• Acts as the primary support contact for the applications endusers.
• Identifies issues that arise in their application areas and issues that impact other application teams and works to resolve them
• Guides workflow design builds tests the system and analyzes other technical issues associated with Epic software
• Identifies implements completes integrated testing and communicates requested changes to the Epic system
• Works with Epic representatives and end users to ensure the system meets the organizations business needs regarding the project deliverables and timeline
• Performs indepth analysis of current and future workflows data collection report details and other technical issues associated with the Epic EHR and designated thirdparty applications
• Partners with quality operational and business leaders on system design and optimization to meet quality safety financial and efficiency needs
• Collects requirements regarding potential system enhancements or new system implementation and prepares details of specifications needed;

prioritizes and implements requested changes to the system.

• Investigates standardization and process improvement opportunities by rounding within revenue cycle areas while making build decisions.
• Validates that data is accurate and meets business requirements.
• Completes integrated testing to test system changes in all Epic environments to ensure that they meet business requirements and do not adversely impact other areas of the system.
• Troubleshoots and identifies root causes and documents problems of simple to medium complexity for assigned applications and systems.
• Maintains data integrity and security for assigned applications and systems.
• Develops system documentation as assigned per standards.
• Develops communicationrelated education efforts for deployments upgrades optimizations and other system changes as assigned.
• Stays current on Epic application releases and participates in upgrade planning and testing.
• Participates in performance improvement activities to measure assess and improve the quality of assigned work area

Education : Essential :

Essential :

Bachelors degree or 8 years experience in directly related field

Credentials : Essential :

Essential :

• Pass general background check
• Epic module certification as assigned
• Epic HB / PB Claims Certification

Skill

Required / Desired

Amount

of Experience

Must have strong leadership and communication skills with the ability to effectively present information to clinical and business leaders within the

Required

Years

Must have experience with Epic PB HB and Claims

Required

Years

Ability to work in small groups under tight project deadlines

Required

Years

Working closely with business and revenue cycle leaders around Epic workflow and to translate business needs Epic billing functionality

Required

Years

Must possess Epic certification Resolute PB HB and Claims

Required

Minimum of five years progressive revenue cycle / healthcare experience with demonstrated experience in Epic build

Required

Years

Selfstarter with demonstrated teamwork & communication skills

Required

Years

Excellent communication and collaboration skills

Required

Years