Job Description
Job title: Technical Specialist- Expert (HB, PB, Claims Analyst) Location: 3700 Wake Forest Rd, Raleigh, NC Duration: 12 Months from projected Interview : Either Webcam Interview or In Person Competency Model: Business Acumen • Understands the organization's 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. • Self-motivated 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 third-party 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: • May be required to work after hours or on weekends as needed • Infrequent travel • Pass pre-employment 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. • Self-starter 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 • No-pay claims. • Claim splits/interim claims. • Cash Management • Self-pay 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 application's end-users. • 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 organization's business needs regarding the project deliverables and timeline • Performs in-depth analysis of current and future workflows, data collection, report details, and other technical issues associated with the Epic EHR and designated third-party 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 communication-related 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: Bachelor's degree or 8 years' experience in directly related field Credentials: Essential: • Pass general background check • Epic module certification as assigned • Epic HB/PB Claims Certification Apply tot his job
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