Epic Professional Billing Claims Analyst - Remote at Optum · Eden…

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Optum’s EHR Services represents one of the fastest growing practices within Optum Insight’s Advisory and Implementations business unit. The EHR Services practice is comprised of 600 individuals across the U.S. and Ireland who are dedicated to improving the healthcare delivery system through the power of healthcare technology, specifically, the EHR and integrated applications and tools. By joining the EHR Services team, you’ll partner with some of the most gifted healthcare technology thought leaders within the industry, collaborate with experienced consulting and healthcare leaders, and help partners capture the benefits of their EHR investment.

Optum seeks an Epic Professional Billing Claims Analyst with hands-on experience supporting Professional Billing claim operations, claims configuration, reimbursement optimization, and revenue cycle transformation initiatives. The analyst will serve as a subject matter expert in Epic Resolute Professional Billing Claims functionality, supporting claim generation, claim edits, charge review workflows, denial prevention, and payer-specific billing requirements. This role will partner closely with operational revenue cycle teams, billing leadership, and technical teams to ensure accurate, timely claim submission and reimbursement outcomes.[NG2]

Solid candidates for this role will be able to demonstrate self-motivation, individual leadership, and team collaboration. Most importantly, our EHR Services team will foster a culture of diversity and inclusion and drive innovation for our company and our clients. 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Working on Professional Billing [KH3] Claims configuration changes and builds by maintaining industry and client standards ensuring build quality and timeline adherence as well as debugging and resolving any issues/defects
• Translate user requirements into functional and technical design specifications and review with client(s) to ensure accuracy
• Serve as a mentor/subject matter expert to client-based [KH4] team members
• Lead medium to large complexity Epic software upgrade initiatives or enhancements to workflows including the design, build, and test phases
• Participate in design and validation sessions and ensure appropriate documentation, follow-up and issue escalation occurs
• Function as a liaison between Operations, Information Technology (IT) and Third-Party Systems
• Provide support of application incidents reported through the help desk; including 24/7 on call coverage as required
• Provide assigned on-site support during go-lives and system upgrades
• Obtain and maintain in-depth knowledge of software functionality; acquire and utilize knowledge of operational workflows to be implemented
• Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with Epic software
• Work with trainers to develop and maintain application specific training curriculum and materials
• Adhere to organization standards for system configuration and change control
• Develop strong relationships with end user communities, customers and business partners
• Attend, participate in, and contribute to meetings throughout the facility

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Active / current Epic certification in Resolute Professional Billing Claims
• 4 years of healthcare experience
• 4 years of experience in an Epic analyst role with function and build experience
• 4 years of knowledge of revenue cycle metrics, KPIs, and process improvement techniques relative to these areas
• 3 years of Direct client healthcare domain knowledge such as billing, payment posting, self-pay/insurance follow up, denial management, customer service or vendor management

Preferred Qualifications:

• Epic Resolute Professional Billing certification[KH5]
• Epic Charge Router Certification
• Completed Epic CEE (Continued Epic Education) to maintain certifications, proficiencies, and badges
• 4 years of knowledge in policies and procedures related to the operational functions
• 2 years of demonstrated ability and history of team management (informal or formal), cross-team communication and leadership skills
• Proficiency with MS Excel, Visio, PowerPoint and SharePoint

Key Competencies:

• Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
• Strong analytical and problem-solving skills
• In-depth knowledge of Epic EMR and the full implementation lifecycle of Epic’s suite electronic medical record applications from conception through development into production
• Ability to work with a minimal amount of supervision, to balance multiple tasks, be detail oriented, set priorities and complete assignments in a timely manner utilizing excellent customer service skills
• Demonstrated ability to translate user requirements into system specifications
• Demonstrates a strong ability to build partnerships and influence others. Work across team, group and business boundaries to drive commonality and reusability in solution to real-world problems
• Excellent written and verbal communication skills

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.