Technical Specialist- Expert HB PB Claims Analyst
Technical Specialist- Expert HB PB Claims Analyst
Posted on :
23-10-2024
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Job Description
NCDHHS is a seeking an experienced Epic PB HB and Claims Analyst .
Required/Desired Skills
Skill Required /Desired Amount of Experience Must have strong leadership and communication skills with the ability to effectively present information to clinical and business leaders within the Required 3 Years Must have experience with Epic PB HB and Claims Required 8 Years Ability to work in small groups under tight project deadlines Required 3 Years Working closely with business and revenue cycle leaders around Epic workflow and to translate business needs Epic billing functionality Required 3 Years Must possess Epic certification Resolute PB HB and Claims Required 0 Minimum of five years progressive revenue cycle/healthcare experience with demonstrated experience in Epic build Required 5 Years Selfstarter with demonstrated teamwork & communication skills Required 3 Years Excellent communication and collaboration skills Required 3 Years
Questions
No. Question Question1 Absences greater than two weeks MUST be approved by CAI management in advance and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you accept this requirement Question2 All work must be completed remotely. Do you accept this requirement Question3 Selected candidate is not permitted to work 2 Epic jobs while contracted with NCDHHS. Do you accept this requirement Question4 Candidate must be able to attend an webcam interview. Do you accept this requirement Question5 Please list candidate s email address. Question6 Please indicate how soon this candidate is available to start work. Vendors are encouraged to submit candidates that are available for the duration of the assignment. Question7 Vendor must disclose to the agency if the candidate will be subcontracted at the time of submission. Do you accept this requirement Question8 Vendor must notify the agency if any portion of the requirements listed in this task order are to be outsourced to other countries. Do you accept this requirement Question9 Candidates submitted above the rate of will not be considered. Do you accept this requirement Question10 Payment for all approved hours will be paid at the straight hourly rate regardless of the total hours worked by the engaged resource. It is the responsibility of the supplier to adhere to any applicable compensation laws including payment for overtime hours. Do you accept this requirement Question11 Please confirm you have thoroughly validated and attest to the accuracy of the credentials listed throughout this candidate s VectorVMS profile and resume pursuant to Section 5.2.5 of ITS009440. Do you confirm 
Competency Model:
Business Acumen
- Understands the organizations 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.
- Selfmotivated 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 thirdparty 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 preemployment 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.
- Selfstarter 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
- Nopay claims.
- Claim splits/interim claims.
- Cash Management
- Selfpay 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 applications endusers.
- 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 organizations business needs regarding the project deliverables and timeline
- Performs indepth analysis of current and future workflows data collection report details and other technical issues associated with the Epic EHR and designated thirdparty 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 communicationrelated 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
Required/Desired Skills
Questions
Employment Type
Full Time
Key Skills
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