Description
PROFESSIONAL OR HOSPITAL BILLING CURRENT CERTIFICATION REQUIRED
Job Summary
Support of Client's EMR in the role of application coordinator working on diverse and complex initiatives in the Billing, Coding, Collections, & Claims arena(Resolute). Interprets fully defined to less defined guidelines to make recommendations for process/system improvements and/or enhancements. Requires complex planning to coordinate with other diverse and multiple stakeholders. Addresses opportunities for process improvement and influencing change. Plans, organizes and manages individual application assignments/tasks to completion. Interacts with other members of the team and other teams, testing, systems integration, IT to complete projects. Influences and guides the technical solution design. Creates solutions for operational and technical problems.
Major Responsibilities/Essential Functions
Change Management:
Submits items for Governance Approval. Manages Vendor's Build/Issue Tracker,
escalates issues to vendor, as appropriate.
Solution Design/Consulting:
Conducts end to end build/technical design reviews. Analyzes existing results routing schemes and troubleshoot issues. Creates new Results Routing Schemes. Independently analyzes, designs, coordinates, and builds complex innovative projects; partners with business owner to define scope and technical solutions; identifies risks and long term effects and cross suite impacts. Support/Utility
Execution: Performs Build, File/Data Conversion Tools/Projects.
Release: Participates in Upgrades and Release Notes management and documentation.
Production Support and Defect Management: Mentors and supports Production Support including on call schedule.
Build and Configuration:
Management: Delivers cutting edge solutions and identifies areas of technical risk. Creates solutions for highly complex issues and requests and complex ancillary initiatives.
Project Management:
Reviews, assesses and integrates ancillary system projects and designs with a high degree of competency. Responsible for technical estimates needed to support core/investment projects.
Communicates with a broad variety of individuals on a broad variety of complex projects and issues which impact the area of management and expertise. Responsible for participating and often planning highly visible and complex initiatives with key stakeholders and business partners and Leadership.
Security, SOX, Compliance, and Change Management:
Follows established security, SOX and Compliance protocols and procedures. Works with Epic on Change requests and complex code or build introduction to the system and assesses impacts accordingly.
Minimum Education & Experience
4-year degree in related field preferred, 2 year degree required
Current EPIC Professional or Hospital Billing Certification (Resolute)
Certification in Hospital and Professional Billing
Minimum Work Experience and Qualifications
4+ years related experience in Application Configuration (Epic Resolute) in a relevant Healthcare setting, Medical Office setting, system implementation and/or installation required. Experience with complex projects. Proven experience and expertise in Epic Resolute billing implementation and Revenue Cycle Initiatives.
Preferred Work Experience and Qualifications
Knowledge and/or direct experience in business/operational area supported by application preferred.
Mastery level knowledge and proven ability of working with CDFs, FDFs, AII overrides, claim edit rules, claim edit workqueues and an excellent understanding and practical comprehension of the 837 electronic form configuration. Applicant should also be extremely familiar with claims batch processing and ePremis. Applicant should also have a comprehensive understanding of Claims systems.