Systems Analyst - Team Lead (Epic HB Claims and Remittance))

UPMC Senior Communities

$95K — $115K *
US-AnywhereRemote in Pittsburgh, PA
Hospitals & Medical Centers
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7+ years of related experience, including 1 year in a senior role or equivalent education/experience.
  • Professional knowledge of IT methods.
  • Understanding of IT strategy and business objectives alignment.
  • Project supervision to ensure completion on time and budget.
  • Decision-making skills based on varied information sources.

Responsibilities

  • Supervise a team of Hospital Billing claims analysts.
  • Apply corrections to CDFs, FDF/ABF, and claim edits based on revenue cycle feedback.
  • Coordinate regulatory updates and edits, including CCI, LCD, and MUE.
  • Guide technical and functional aspects of claims and remittance administration.
  • Collaborate with the Professional Billing Claims team on projects and system issues.

Benefits

  • Remote work opportunity.
  • Professional development and continuing education.
  • Supportive team environment and collaborative culture.
  • Exposure to advanced IT methodologies in healthcare.
Full Job Description
Systems Analyst - Team Lead (Epic HB Claims and Remittance)) UPMC is hiring a Systems Analyst - Team Lead to manage their highly accomplished Hospital Billing Claims team. Candidates with exceptional experience in Epic HB claims generation, remittance processing and denial management are encouraged to apply. Work Location: Remote Responsibilities: • Supervises a team of several HB claims analysts. • Utilize direct feedback from revenue cycle operations to apply corrections to CDFs, FDF/ABF and claim edits. • Coordinate Claims-owned regulatory updates and edits (CCI, LCD, MUE) as well as periodic Epic upgrades (Nova Notes) • The position is expected to provide strong technical and functional guidance of claims and remittance administration. • Work collaboratively with the Professional Billing Claims team on shared projects and system issues. Qualifications: • Seven years of total related experience, including one year experience as a senior or lead, OR equivalent combination of education/experience. (Claims & Remittance) • Professional knowledge of IT methods. • Proficient understanding of IT strategy and how it relates to business objectives. • Ability to successfully supervise projects to completion on time and within budget. • Ability to make decisions or recommendations based on various types and amounts of information. Top Skills Needed: • Must have current Epic HB Claims and Remittance certification and at least 7 years of experience. • Robust problem-solving skills. Ability to leverage Epic UserWeb for research and Epic Sherlock to escalate complex issues to Epic TS for guidance. • Superior communication skills (verbal and written) • Experience with ticket triaging applications (ServiceNow, or instance) • Ability to enforce UPMC corporate change control policies Must Have Current certification in any of the following: • Epic HB Claims and Remittance

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