CBO Revenue Cycle Applications Analyst

Nemours - Jacksonville, FL

Full-time

Remote - Jacksonville, FL

Hospitals

About the position

The CBO Revenue Cycle Applications Analyst plays a crucial role in supporting the Central Business Office (CBO) and other Nemours affiliates by ensuring the accurate and timely transmission of professional and hospital electronic and paper claims. This position involves troubleshooting claims issues, maintaining and updating claims setups within Epic applications, and collaborating with various departments to enhance the efficiency of the revenue cycle process. The analyst is also responsible for identifying opportunities for process improvement and acting as a resource for end users.

Responsibilities

• Assist Central Business Office associates, end users, and leadership with claim related issues via Help tickets and/or claims projects to increase prompt payment and decrease rejections.
• Create and maintain custom programming and rules for electronic and paper claims submissions following all insurance payor, State, ANSI, and other standard billing guidelines.
• Create, maintain, monitor, and resolve claims issues in assigned Epic Claim and Account & Follow-up workqueues.
• Create and maintain Remittance Options (RMOs) for electronic remittance posting.
• Work with clearinghouse and other partners to ensure accurate claims transmission from clinics and hospitals into the payer's system.
• Collaborate with Nemours Health Informatics and IS Departments for claims setup, claim status troubleshooting, and remittance workflows.
• Work with assigned Epic Technical Support on Epic support log tickets, custom changes/fixes, Release Notes, and Epic upgrades.
• Participate in the evaluation, testing, and validation of new release and upgrade functionality.
• Attend scheduled huddles and meetings to discuss team and project related activities, issues, changes, communications, and updates.

Requirements

• Some College education required.
• Professional and/or Hospital Billing Claims Administration EPIC Certification (or completion within 6 months of hire date) required.
• More than 1 year and up to 3 years of experience in a healthcare related field, business office, or managed care setting.
• Understanding of the claims revenue cycle, including standard billing procedures (NUCC, NUBC, and ANSI), payments/denials by commercial and Medicaid health insurers.
• Ability to apply critical thinking skills to building and testing of Epic applications.
• Ability to work independently and meet project guidelines/timelines.