HB Claims Analyst II

Position Summary

The Epic Hospital Billing Claims and Remittance Analyst II is responsible for supporting and optimizing Epic’s Resolute Hospital Billing (HB) module, focusing on claims processing and remittance workflows. This role ensures accurate and timely claim submissions, compliance with payer requirements, and effective collaboration across departments to resolve billing issues.

Key Responsibilities

• Configure and maintain Epic HB Claims and Remittance workflows.
• Process and manage hospital billing claims using Epic Resolute HB.
• Monitor claim edits, rejections, and denials; implement solutions to improve clean claim rates.
• Collaborate with Revenue Cycle, IT, Compliance, and clinical teams to optimize billing operations.
• Analyze trends in claim denials and reimbursement delays.
• Support system upgrades, testing, and documentation of Epic build changes.
• Ensure data integrity using tools like Experian or clearinghouse platforms.
• Provide training and support to end-users and operational teams.
• Participate in operational meetings and provide subject matter expertise.

Qualifications

• Epic Certification in Resolute Hospital Billing Claims and Remittance Administration.
• 4–6 years of experience in Epic HB Claims.
• Strong understanding of hospital billing operations, claims submission, and remittance processes.
• Experience with 837/835 files, payer configurations, and clearinghouse workflows.
• Ability to work independently and manage multiple priorities.
• Excellent analytical and problem-solving skills.

Preferred Qualifications

• Experience in large hospital or integrated health systems.
• Familiarity with Behavioral Health or Ambulatory billing workflows.
• Knowledge of Epic reporting tools (e.g., Reporting Workbench, Clarity).
• Bachelor’s degree in Healthcare Administration, IT, Business, or related field.