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Epic Claims and Remittance Analyst

Company: Optum
Location: Everett
Posted on: January 12, 2022

Job Description:

JOB SUMMARY: Under general supervision, responsible for the on-going assessment, design, development, testing, support, training and maintenance of EPIC System build as it pertains to PB Claims and Remittance . Participates fully in the EPIC project team; will become the key subject matter expert and act as the liaison between clinics and the project team. Will perform at the highest technical level of all phases of EPIC application systems analysis, workflow analysis, build and testing. Responsible for leading projects and optimization of initiatives.ESSENTIAL DUTIES & RESPONSIBILITIES: The duties listed below are intended only as illustrations of the various types of work that may be performed.-- The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment.98%------ Epic System Build

  • Responsible for core system build and on-going maintenance
  • Define system setup requirements
  • Document system setup
  • Participate in system design process
  • Document current clinic flows
  • Work with all levels of system users to determine system setup needs and modifications
  • Participate in upgrades and special updates
  • Track system enhancement requests
  • Work with Epic technical staff and implementers to resolve application issues
  • Learn Epic technology and perform many system maintenance tasks such as system imports, basic reporting and system configuration
  • Works closely with team
  • Complete and keep Epic Certification(s) current
  • Ensure system build is done in adherence with TEC polices
  • Collect and transform large quantities of information into meaningful business requirements
  • Develop and modify requirements documentation for the design and implementation of the Epic system
  • Critically evaluate information from various sources
  • Distinguish user needs from business needs and partner with all teams in optimizing scope, benefits and risks of actual and proposed projects as well as assist in managing stakeholder expectationsTesting and Quality Assurance----
    • Adhere to all EPIC and change control processes
    • Develop and utilize testing plans and scripts
    • Assist in the recommendation and development of policies related to the use of Epic
    • Ensure changes communicated to team and impacted system users in a timely mannerTraining--
      • Work closely with trainers on all changes and new features
      • Train individuals or groups as needed
      • Attend regular clinic meetings to improve user knowledge of the Epic systemUser Support--
        • Provide customer service to all staff to support/troubleshoot application problems
        • Troubleshooting and documentation of system issues
        • Documentation of FAQ and common solutions
        • Meet or exceed customer service standardsProject Management
          • Ability to document key tasks and milestones associated with new functionality
          • Ability to set and manage to timelines
          • Ability to prioritize and communicate potential barriers to success
          • Partner with project managers to complete requirements documentation in accordance with project schedule.
          • Plan, organize, facilitate, and lead meetings and workgroups as well as oversee and execute follow-up activities.
          • Define external interfaces, constraints and quality issues.
          • Provide project management team with identified risks, concerns, and ambiguities discovered during the requirements phase; assist team in developing solutions.
          • Plan, coordinate, and support unit acceptance testing and subsequent deployments in coordination with other team leaders.
          • Develop and execute project presentations.
          • Participate in special projects as requiredLeadership
            • Provide training, direction and mentoring for associate and intermediate application analysts and/or other appropriate project team members
            • Participate in selection of associate and intermediate application analysts, consultants, and/or other appropriate project team members.
            • Identify opportunities for process improvements and provide analysis and propose change and communicate strategies.Duties listed below are integrated into all job functions:
              • All staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous and respectful manner toward fellow employees, physicians and patients.
              • Must relate to other people beyond giving and receiving instructions: (a) get along with co-workers or peers without exhibiting behavioral extreme; (b) perform work activities requiring negotiating, instructing, supervising, persuading or speaking with others; and (c) respond appropriately to feedback regarding performance from a supervisor.
              • Performs all duties in a manner which promotes and supports the core values of The Everett Clinic.
              • Integrates Lean principles, practices and tools to improve operational efficiency, reduce costs and increase customer satisfaction.
              • Frequently must follow written and oral instructions as well as complete routine tasks independently.
              • Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signs Agreements.
              • Ensures confidentiality of patient information following HIPAA guidelines and TEC policies.
              • Attends training to meet requirements of the job position and as needed or mandated by TEC policies, Div. of Occupational Safety & Health (DOSH), OSHA, L&I and other state/federal regulations.
              • Has regular and predictable attendance.NON-ESSENTIAL DUTIES & RESPONSIBILITIES: --2% Performs other duties as assigned.QUALIFICATIONS:Education: Bachelor's Degree in related field or equivalent experience.Experience: Minimum of three to five years healthcare experience preferred.-- Three to five years working with clinical systems preferred. Minimum of two full life-cycle implementations preferred. Clinical background for front-end roles preferred. Technical experience for back end roles preferred.-- Proficiency with all Microsoft products.Certificate/License: --Minimum of one EPIC Certification required.Additional Requirements: UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status. Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.--Knowledge, Skills & Abilities: Note that these requirements are representative, but not all-inclusive, of the knowledge, skill, and ability required to perform this job.Knowledge: Proven knowledge of health care organizations and clinic flow and standards. Knowledge of clinical systems. Knowledge of system implementations preferred.Skills: Must be courteous, responsive, timely, respectful, thorough and detail oriented. Possesses excellent oral and written communication and problem-solving skills. Has good time management skills and a demonstrated ability to prioritize tasks.Abilities: Ability to work with all levels of staff to determine clinic needs and best practices. Ability to keep professional demeanor in stressful circumstances. Ability to work independently and in team environments.TYPICAL WORKING CONDITIONS:-- Work is performed in an office environment. Occasional extra hours and possible weekends. Involves daily contact with receptionists, clinical staff, supervisors, managers and physicians. Work may be stressful at times.PHYSICAL DEMANDS: Requires sitting for long periods of time, bending over desks, reaching and stretching for items.-- Requires long hours at the computer terminal and keyboard.-- May involve lifting of up to 50 pounds of paper or light terminal equipment.-- Travels to and from multiple client clinics' sites.CONTACT RELATIONSHIPS: Clinic employees, physicians, IT staff and vendors.

Keywords: Optum, Everett , Epic Claims and Remittance Analyst, Professions , Everett, Washington

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