Certified Epic Claim Analyst Jobs (NOW HIRING)

Summary:

The HB Certified Epic Analyst is a subject matter expert in Epic Resolute Hospital Billing (HB), responsible for the design, configuration, and ongoing optimization of HB workflows that drive accurate, compliant, and efficient revenue cycle performance. This role sits at the intersection of technical Epic build and operational revenue cycle knowledge, translating billing, claims, and reimbursement requirements into system configuration that works in the real world of payer rules, work queues, and daily production volume. This individual owns HB build components including charge router logic, work queue (WQ) design and routing rules, claims edits, Bridges/BCB configuration, and statement workflows, while partnering closely with billing, coding, denials, and client operations teams to ensure the build supports front-line staff rather than working against them. The Analyst supports go-lives, system upgrades, optimization initiatives, and day-to-day production issue resolution across client and internal Epic environments. This is an opportunity to build deep, marketable Epic expertise while working across multiple revenue cycle environments and client engagements - with a clear path toward Senior Analyst, Team Lead, or Principal Consultant roles for professionals who combine strong Epic HB build skills with revenue cycle judgment.

Duties and Responsibilities:

Epic HB Build, Configuration & Optimization

• Knows, understands, incorporates, and demonstrates the Healthrise Core Values in all interactions with team members, clients, and stakeholders.

• Designs, builds, tests, and maintains Epic Resolute Hospital Billing (HB) configuration, including charge router rules, claims edits, and account-level workflows.

• Designs and manages work queue (WQ) structure, routing logic, and assignment rules to optimize staff productivity and claim throughput.

• Configures and supports Bridges/BCB (Bridge Batch/Charge Batch) interfaces, statement processing, and remittance workflows.

• Uses Slicer Dicer and Epic reporting tools to build ad hoc reports, monitor build performance, and identify workflow breakdowns.

• Partners with Epic PB, Cadence, and Claims teams to ensure HB build integrates cleanly across the full revenue cycle application suite.

Revenue Cycle & Regulatory Application

• Applies current knowledge of CPT, ICD-10-CM, HCPCS, revenue codes, UB-04 claim requirements, and CMS billing guidelines to HB build and issue resolution.

• Stays current on payer-specific billing rules, CMS regulatory updates, and Epic release notes that impact HB configuration and claim accuracy.

• Supports coding and billing quality reviews, denial root-cause analysis, and underpayment investigations by identifying and correcting build-related contributors.

• Ensures HB configuration and workflows remain compliant with HIPAA, payer contracts, and applicable federal and state billing regulations.

Project & Go-Live Support

• Supports Epic HB go-lives, system upgrades, module implementations, and optimization projects as a build subject matter expert.

• Translates end-user and business owner needs into system specifications, test scripts, and configuration requirements.

• Participates in unit, integration, and regression testing; documents test results and defects, and validates fixes prior to release.

• Develops and maintains build documentation, SOPs, and job aids so configuration decisions remain transparent and supportable over time.

• Manages change control for assigned HB build items, including risk assessment and coordination with other Epic application teams.

Production Support & Issue Resolution

• Serves as an escalation point for HB-related production tickets, work queue breakdowns, and claim edit issues affecting billing operations.

• Conducts root-cause analysis on recurring billing errors, denial trends, or claim rejections tied to system configuration.

• Collaborates with billing, AR, and denials staff to validate that build changes resolve the underlying operational problem, not just the reported symptom.

• Performs other duties as assigned.

Required:

• Bachelor’s degree in Healthcare Administration, Information Systems, Business, or a related field; or equivalent combination of education and progressive experience.

• Active Epic Resolute Hospital Billing (HB) certification required.

• Minimum 3 years of hands-on Epic HB build, configuration, or analyst experience in a live production environment.

• Working knowledge of UB-04 claim forms, CPT, ICD-10-CM, HCPCS, and revenue codes, and how they translate into HB build logic.

• Demonstrated experience with work queue design, charge router configuration, claims edits, and Bridges/BCB workflows.

• Familiarity with Slicer Dicer or comparable Epic reporting tools for build validation and issue investigation.

• Understanding of CMS billing guidelines, payer policy variation, and how regulatory change translates into system configuration updates.

• Strong analytical and troubleshooting skills, with the ability to isolate root cause across data, workflow, and system build.

• Effective written and verbal communication skills; comfortable working directly with end users, business owners, and cross-functional Epic teams.

• Completion of regulatory/mandatory certifications as required.

• Willingness and ability to travel to client or organizational sites as needed.

Preferred:

• Additional Epic certification(s) beyond HB, such as Resolute Professional Billing (PB), Cadence, or Claims/Remittance.

• Industry credentials such as Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or an HFMA-aligned certification.

• Experience supporting Epic go-lives, conversions, or optimization projects in a multi-client, consulting, or BPO/outsourced RCM environment.

• Exposure to revenue integrity, CDM (Charge Description Master) build, or Epic-adjacent automation and AI-assisted coding tools.

• Experience with Lean, Six Sigma, or other continuous improvement methodologies applied to revenue cycle workflow redesign.