Epic Hospital Billing Claims Consultant

WHO WE ARE

Pivot Point Consulting enables healthcare organizations to realize the most value from their technology and resources through Managed Services, Data & Analytics, EHR, ERP, Advisory, Virtual Care and Cybersecurity services. Its award-winning industry experts deliver Consulting, Managed Services and Talent Solutions to providers, payers, life sciences and technology organizations.

The firm is currently ranked #1 Best in KLAS: Managed IT Services and has been repeatedly recognized as a top performer by KLAS in multiple categories, including #2 Best in KLAS: Partial IT Outsourcing (renamed Managed IT Services in 2023) and Best in KLAS: Overall IT Services Firm in 2022 and #1 Best in KLAS: Overall IT Services Firm in 2020. For more information, visit pivotpointconsulting.com.

ROLE

The Epic Hospital Billing Claims Consultant will be responsible for analyzing, configuring, and optimizing the Epic Hospital Billing (HB) module to improve claims processing and revenue cycle performance. This role requires in-depth knowledge of Epic systems, hospital billing workflows, and healthcare reimbursement methodologies. The consultant will work closely with the billing, finance, and IT teams to ensure the successful implementation and optimization of Epic HB functionalities.

RESPONSIBILITIES

Analyze current billing workflows and identify areas for improvement.

Configure and optimize the Epic HB module to support efficient claims processing and billing operations.

Ensure that the Epic system is set up to accurately capture and process billing information according to industry standards and regulatory requirements.

Oversee the end-to-end claims management process, from charge capture to claims submission and follow-up.

Monitor claims for accuracy, completeness, and compliance with payer requirements.

Work with the billing team to resolve claim denials and rejections promptly.

Collaborate with revenue cycle stakeholders to design and implement efficient billing workflows.

Provide recommendations for process improvements to enhance revenue capture and reduce billing errors.

Develop and maintain documentation for billing processes and system configurations.

Provide training and support to billing staff on Epic HB functionalities and best practices.

Develop training materials and conduct workshops to ensure effective use of the Epic system.

Offer ongoing support to address any system-related issues or questions from end-users.

Generate and analyze reports on billing and claims performance to identify trends and areas for improvement.

Provide insights and recommendations to leadership based on data analysis.

Ensure accurate and timely reporting of key performance indicators (KPIs) related to billing and claims.

Ensure that billing processes comply with all applicable regulations, including HIPAA, CMS guidelines, and payer requirements.

Conduct regular audits to verify the accuracy and integrity of billing data.

Implement quality assurance measures to prevent and address billing discrepancies.

EXPERIENCE

Bachelor’s degree in Healthcare Administration, Business, Information Technology, or a related field.

Minimum of 5 years of experience in hospital billing and claims management, with a strong focus on Epic HB.

Epic HB certification required.

Vaco is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law .

Determining compensation for this role (and others) at Vaco depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law, Vaco believes that the following salary range reasonably estimates the base compensation for an individual hired into this position in geographies that require hourly pay range disclosure: $65 - $80.
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