CBO Revenue Cycle Applications Analyst

Nemours - Jacksonville, FL

Full-time - Mid Level

Jacksonville, FL

Hospitals

About the position

The CBO Revenue Cycle Applications Analyst at Nemours is responsible for supporting the Central Business Office (CBO) and other affiliates by ensuring accurate and timely transmission of professional and hospital electronic and paper claims. This role involves addressing claims processing errors, maintaining and updating claims setup within Epic applications, and collaborating with various departments to enhance workflows and optimize the revenue cycle. The analyst acts as a resource for end users and leadership, focusing on process improvement and education to support the strategic mission of Nemours.

Responsibilities

• Provide direct support to the Central Business Office and affiliates for claim-related issues.
• Ensure timely and accurate transmission of electronic and paper claims to responsible parties.
• Maintain, update, and correct PB/HB Claims and Remittance setup within Epic applications.
• Test and validate system builds and new release functionalities.
• Maintain electronic and paper claim submission forms and related items.
• Set up Resolute Master Files to support claims and remittance processes.
• Collaborate with CBO representatives and internal departments to analyze workflows and technical issues.
• Create and maintain custom programming and rules for claims submissions according to billing guidelines.
• Monitor and resolve claims issues in assigned Epic workqueues.
• Create and maintain Remittance Options for electronic remittance posting.
• Work with clearinghouse partners to ensure accurate claims transmission.
• Assist with claims setup and troubleshooting in collaboration with Health Informatics and IS Departments.
• Participate in evaluation, testing, and validation of new release functionalities.

Requirements

• Some college education required.
• Professional and/or Hospital Billing Claims Administration EPIC Certification (or completion within 6 months of hire date) required.
• Minimum of 1 year experience in a healthcare-related field, business office, or managed care setting.
• Understanding of the claims revenue cycle and standard billing procedures (NUCC, NUBC, ANSI).
• Ability to apply critical thinking skills to building and testing Epic applications.
• Ability to work independently and meet project guidelines and timelines.