Epic PB Analyst
Core
Transition Optum Claims Manager edits into Epic charge review edits and optimize Charge Router workflows for accurate billing.
Role type
Senior IC Epic Professional Billing Analyst
Builds
Regulatory and coding-related edits (LCD/NCD, CCI/NCCI, MUE) and optimized Charge Router configurations
Domain
Healthcare Revenue Cycle Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Epic Resolute Professional Billing Administration certification, Epic Charge Router configuration, regulatory edit implementation (LCD/NCD/CCI/NCCI/MUE), workqueue optimization, requirements translation, independent project leadership
Preferred skills
Optum Claims Manager transition experience, large-scale Charge Router cleanup, reducing third-party tool reliance
Technologies
Epic Resolute, Optum Claims Manager
Responsibilities
Lead transition of Optum Claims Manager edits to Epic charge review edits; Analyze, configure, test, and optimize Epic charge review edits; Build and maintain regulatory and coding-related edits; Perform Epic Charge Router cleanup and optimization; Configure and optimize Professional Billing workqueues; Troubleshoot charge routing, edit, and workqueue issues; Partner with stakeholders to translate regulatory requirements into Epic build; Lead assigned workstreams independently from analysis through implementation.
Seniority
Senior, hands-on IC