Epic HB/PB Resolute Claims Analyst

Job Summary

We are seeking an experienced Epic Resolute Hospital Billing (HB),or Professional Billing (PB), and Claims Analyst to support, maintain, and optimize Epic Revenue Cycle applications. The ideal candidate will have hands-on experience with Epic Resolute HB, PB, Claims, and Revenue Cycle workflows, along with strong analytical and troubleshooting skills. Active Epic certification is mandatory.

Key Responsibilities

• Configure, maintain, and support Epic Resolute HB, PB, and Claims applications.
• Analyze business requirements and translate them into Epic system solutions.
• Support claim generation, claim edits, remittance processing, and denial management workflows.
• Troubleshoot application issues and provide timely resolution.
• Perform system build, configuration, testing, upgrades, and optimization activities.
• Collaborate with Revenue Cycle, Patient Financial Services, and IT teams.
• Create and maintain application documentation, workflows, and training materials.
• Participate in integrated testing, go-live support, and post-implementation activities.
• Ensure compliance with healthcare billing regulations and organizational standards.
• Support enhancement requests and continuous process improvement initiatives.

Requirements

Preferred Skills

• Knowledge of Charge Router, Work Queues (WQs), Claims, Remittance, Payment Posting, and Revenue Cycle workflows.
• Experience with Epic upgrade testing and release management.
• Understanding of healthcare billing regulations, payer requirements, and reimbursement processes.
• Experience in hospital and professional billing environments.

Education

• Bachelor's degree in Healthcare, Information Technology, Computer Science, or a related field preferred.

Mandatory Certification

• Epic Resolute Hospital Billing (HB) Certification.
• Epic Resolute Professional Billing (PB) Certification.
• Epic Claims/Remittance Certification is a strong plus.

Preferred Experience

• Healthcare IT implementation, optimization, or application support experience.
• Experience working directly with Revenue Cycle and Patient Financial Services teams.