Supports Epic Resolute Professional Billing initiatives, including migrating Optum Claims Manager edits, configuring charge review edits, optimizing Charge Router rules, and maintaining PB workqueues. Troubleshoots charging and billing workflows, implements regulatory and coding edits, translates revenue cycle requirements into Epic configuration, and leads analysis, testing, validation, documentation, implementation, and knowledge transfer with Revenue Cycle, Coding, Compliance, and operational stakeholders.
This is a remote position.
Superlanet is seeking an experienced Epic Resolute Professional Billing (PB) Analyst to support our West Coast-based healthcare client. This is a remote, six-month contract opportunity with an anticipated start as soon as possible.
The Epic PB Analyst will play a key role in transitioning Optum Claims Manager edits into Epic charge review edits, while also supporting Charge Router cleanup and optimization. The ideal candidate will bring strong expertise in Epic Professional Billing, regulatory edits, charging workflows, Charge Router, and workqueues and be comfortable taking ownership of these initiatives.
- Lead the transition of applicable Optum Claims Manager edits to Epic charge review edits.
- Analyze, configure, test, and optimize Epic charge review edits to support accurate and compliant billing workflows.
- Build and maintain regulatory and coding-related edits, including:
- LCD/NCD – Local and National Coverage Determinations
- CCI/NCCI – Correct Coding Initiative edits
- MUE – Medically Unlikely Edits
- LCD/NCD – Local and National Coverage Determinations
- Perform Epic Charge Router cleanup and optimization, identifying outdated, redundant, or inefficient rules and configurations.
- Evaluate existing charging workflows and recommend opportunities to improve automation, accuracy, and efficiency.
- Configure and optimize Professional Billing workqueues supporting charge review and billing operations.
- Troubleshoot charge routing, edit, and workqueue issues and identify root causes.
- Partner with Revenue Cycle, Coding, Compliance, and operational stakeholders to translate regulatory and business requirements into Epic build.
- Lead assigned workstreams independently, including requirements gathering, build, testing, validation, documentation, and implementation.
- Support knowledge transfer and documentation to ensure long-term maintainability of the updated Epic workflows.
- Active Epic Resolute Professional Billing Administration certification required.
- Strong hands-on Epic Resolute Professional Billing build and configuration experience.
- Demonstrated experience with Epic Charge Router, including rule configuration, troubleshooting, cleanup, and optimization.
- Strong understanding of charge review edits, charging workflows, and PB workqueues.
- Hands-on experience implementing or maintaining healthcare regulatory and coding edits, including LCD/NCD, CCI/NCCI, and MUE requirements.
- Experience translating billing and regulatory requirements into Epic configuration.
- Strong understanding of the revenue cycle and the relationship between charging, coding, claims, and billing workflows.
- Ability to independently lead complex Epic PB initiatives from analysis through implementation.
- Strong communication skills with the ability to collaborate effectively with technical, operational, coding, compliance, and Revenue Cycle teams.
- Previous experience transitioning edits or functionality from Optum Claims Manager into Epic.
- Experience with large-scale Charge Router cleanup or optimization initiatives.
- Experience reducing reliance on third-party claims or billing tools by moving functionality directly into Epic.
Benefits
Pay rate based on experience and qualifications $75.00 - $85.00/hr +
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