Sr Epic HB Analyst - Remote

Title: Epic Sr HB Claims Analyst
Location : Remote: Excluding, NY. CA., CO
Target Start Date : 11/30
Type: (C, CTH, D) Direct
Pay Rate / Salary (Ranges OK) : $110,000 -$120,000 - W/ 10% bonus
To note: 25% travel

Senior Epic HB Claims Analyst

About the Organization

Our client is a nationally recognized healthcare services organization that partners with hospitals, health systems, and physician groups to improve operational performance, financial outcomes, and patient experiences. With a strong focus on innovation, continuous improvement, and technology-enabled solutions, the organization supports healthcare providers across the country in optimizing critical business and clinical operations.

The organization fosters a collaborative and client-focused culture where employees are empowered to solve complex challenges, deliver measurable results, and drive meaningful improvements for healthcare organizations. Professionals joining the team will have the opportunity to work directly with healthcare leaders, contribute to strategic initiatives, and support transformative technology programs that impact patient care and operational excellence.

Position Summary

We are seeking an experienced Senior Epic HB Claims Analyst to serve as a trusted advisor and technical resource for healthcare organizations seeking to optimize their Epic Hospital Billing (HB) Claims operations. This position focuses on Epic HB Claims build, workflow optimization, system enhancements, issue resolution, and ongoing support of revenue cycle operations.

The ideal candidate will possess deep expertise in Epic HB Claims, claim edits, billing workflows, reimbursement optimization, and denial prevention. This individual will partner with operational and technical stakeholders to improve clean claim rates, accelerate reimbursement, and enhance overall revenue cycle performance.

Essential Responsibilities

Epic HB Claims Support & Optimization

• Analyze, design, configure, test, and support Epic HB Claims application build and enhancements.
• Evaluate existing billing and claims workflows to identify opportunities for operational improvement and reimbursement optimization.
• Serve as the lead analyst for HB Claims-related issues, enhancement requests, and optimization initiatives.
• Develop recommendations that align Epic functionality with revenue cycle best practices.
• Configure and optimize claim edits, billing rules, claim generation processes, reimbursement workflows, and workqueue functionality.
• Partner with operational and technical stakeholders to implement workflow improvements and system enhancements.
• Support initiatives focused on reducing denials, improving clean claim rates, and accelerating cash collections.

System Build, Testing & Change Management

• Perform Epic HB build and configuration activities following established change control processes.
• Create and maintain workflow documentation, build specifications, and decision documents.
• Participate in integrated testing, user acceptance testing (UAT), upgrades, and implementation activities.
• Troubleshoot application issues and coordinate resolutions with internal teams and Epic resources.
• Manage support tickets and prioritize issue resolution to meet client expectations.
• Support Epic upgrades and ensure claims functionality remains aligned with operational requirements.

Client Engagement & Consulting

• Act as a subject matter expert for Epic HB Claims and hospital billing workflows.
• Facilitate requirements gathering sessions and stakeholder meetings.
• Communicate project status, recommendations, and system impacts to client leadership and operational teams.
• Educate end users and leadership on Epic best practices and system functionality.
• Support implementation, optimization, and continuous improvement initiatives.
• Collaborate with Patient Financial Services, Revenue Integrity, HIM, Coding, Billing, and Revenue Cycle leadership teams to improve claims performance and reimbursement outcomes.

Required Qualifications

• Active Epic Hospital Billing (HB) Certification (verification required).
• Minimum 4 years of recent Epic HB Claims experience.
• Hands-on Epic build, support, optimization, and enhancement experience.
• Strong understanding of hospital billing and claims management workflows, including:
  • Claims processing
  • Claim edits and workqueues
  • Revenue cycle operations
  • Denial management
  • Reimbursement workflows
  • Revenue Integrity processes
  • Medicare, Medicaid, and Commercial payer billing requirements
  • Accounts Receivable (A/R) management
• Experience gathering business requirements and translating operational needs into Epic solutions.
• Strong analytical, problem-solving, and troubleshooting skills.
• Excellent communication and interpersonal skills with proven client-facing experience.
• Ability to work independently while managing multiple priorities and deliverables.
• Ability to travel approximately 25% (typically one week per month, based on client needs).

Nice to Have Qualifications

• Epic Hospital Billing Claims Administration Certification
• Epic Resolute HB Certification
• Epic Prelude Administration Certification
• Epic Real-Time Eligibility (RTE) experience
• Epic Referral Administration experience
• Epic implementation and optimization experience
• Experience supporting denial prevention and revenue cycle transformation initiatives
• Experience with payer reimbursement optimization
• Experience working with healthcare operational leadership and cross-functional teams
• Consulting experience supporting multiple healthcare organizations

Success in This Role

The successful candidate will:

• Demonstrate deep expertise in Epic HB Claims and hospital revenue cycle operations.
• Identify opportunities to improve claims processing efficiency and reimbursement outcomes.
• Build strong relationships with client stakeholders through effective communication and collaboration.
• Deliver scalable solutions that improve clean claim rates, reduce denials, accelerate cash collections, and optimize reimbursement performance.
• Support healthcare organizations through ongoing optimization efforts, upgrades, and Epic initiatives.
• Help clients improve key revenue cycle metrics, including:
  • Clean claim rates
  • First-pass resolution rates
  • Denial rates
  • Accounts receivable performance
  • Cash collections
  • Net revenue realization

Hiring Process

• Initial interview (30-45 minutes)
• Panel interview with 3-4 team members
• Comprehensive background screening process

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