SoluStaff

Epic Certified Home Health Claims Analyst

US-NY-New York
6 months ago
ID
2017-1326
# of Openings
1
Category
Information Technology

Overview

SoluStaff is actively recruiting for an Epic Certified Home Health Billing Claims Analyst for our Healthcare client in Manhattan.  This position requires a seasoned Epic home health billing analysts who has a deep knowledge of Home Health revenue cycle management and Epic’s Home Health Billing module. The analysts should be able to support the implementation of Charge, Claims, Statement and Remittance, RTE and Batch Eligibility, as well as workqueue processing, reports and dashboards.

 

Responsibilities

  • Support and build out the Epic Home Health Billing application and Claims
  • Interview users, stakeholders, and sponsors to assess departmental needs to create Business, functional and technical requirements documents
  • Analyze and document client's business requirements and processes; communicate requirements to technical personnel by constructing basic conceptual data and process models,
  • including process flowcharts and technical specifications
  • Decompose information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs
  • Define external interfaces, constraints, quality and other non-functional requirements
  • Excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts
  • Provide Project Management with identified risks, concerns, and ambiguities discovered during requirements gathering and work with the Project Manager to complete requirements
  • documentation on schedule
  • Identify opportunities for process improvements and provide analysis, propose change strategies, and communicate proposed strategies appropriately
  • Ensure software development team accounts for all defined requirements during development and coordinate with QA team for maximum application coverage
  • Documentation of Software Test Plans, Technical Documentation, Release Notes, User
  • Guides, and Training and other materials as necessary
  • Participate in special projects as needed and performs other duties as assigned

Qualifications

  • Claims Administration required, certification in Resolute Hospital Billing Administration required
  • Home health Billing Certification required
  • Certification in Resolute Hospital Billing Expected Reimbursement Contracts, certification in
  • Resolute Hospital Billing Electronic Remittance and certification in Epic Eligibility preferred
  • 3+ years’ experience implementing and supporting Epic Home Health Billing and Epic Resolute
  • Hospital Billing Claims
  • Have a full understanding of the PPS and non-PPS Home Health Billing revenue cycle and the revenue cycle as it pertains to Epic
  • Support functions pertaining to RAP, Billing, Claims, Payment Posting, insurance and guarantor follow-up, remittance processing, denial management, management reporting and dashboards
  • Should have experienced a minimum of two Epic Home Health Billing go-lives
  • Knowledge of: RAP processing, OASIS, HHRG, Claims Rules Editing (CDF), Claims processing, Configuration of AR buckets, workflows, workqueues, adjustments, statements
  • Must be knowledgeable in ADT/Prelude, Cadence, Identity, HIM/Coding Deficiency modules
  • Testing: configuration, integration, end-to-end including downstream
  • Build and maintain WorkQueues
  • Report-writing knowledge
  • A Baccalaureate Degree from an accredited college or university in computer science, Information systems, business administration or equivalent experience or education is required.
  • Possesses excellent organizational skills and is detail oriented, highly analytical and possess strong problem solving skills
  • Excellent communication skills and ability to present concepts in a concise and focused manner, including narrative, process diagrams, role and accountability diagrams and business- focused story boards
  • Demonstrates the ability to work on multiple projects simultaneously and prioritize work to meet adapting deadlines
  • Experience and knowledge of the Microsoft Office Suite including Visio and Project
  • Understanding of software User Interface design, software development life cycle or Joint
  • Application Development, and knowledge or exposure to project management methodologies

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