Epic HB/PB Analyst - CST

Optum is seeking two experienced Epic Resolute HB/PB Analysts to support revenue cycle optimization and reimbursement contract initiatives. This individual will work closely with Revenue Cycle, Operations, and Payer Relations teams to build, maintain, and optimize Epic Hospital Billing (HB) and Professional Billing (PB) functionality. The ideal candidate will possess strong experience with reimbursement contracts, payer agreement interpretation, claims processing, reimbursement variance analysis, and Epic build/configuration.

Day to Day/Responsibilities:

• Build, configure, and maintain Epic Resolute Hospital Billing (HB) and Professional Billing (PB) applications.

• Interpret payer agreements and translate contract language into Epic reimbursement contract builds.

• Analyze reimbursement variances and troubleshoot billing and contract configuration issues.

• Perform contract audits and identify opportunities to improve reimbursement accuracy.

• Support testing, validation, implementation, and optimization of Epic revenue cycle workflows.

• Collaborate with Revenue Cycle, Finance, Operations, and IT stakeholders to implement system enhancements.

• Utilize Epic reporting tools to identify contract build discrepancies and reimbursement issues.

• Document configurations, testing results, and project updates throughout the lifecycle of initiatives.

Assist with backlog reduction efforts related to existing payer contract and reimbursement build issues.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global’s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

Must Haves:

• 5+ years of Epic Resolute HB and/or PB Analyst experience.

• Active Epic Resolute Hospital Billing (HB) Certification.

• Active Epic Resolute Professional Billing (PB) Certification.

• Experience building and maintaining Epic reimbursement contracts.

• Strong understanding of hospital and professional revenue cycle workflows.

• Experience interpreting payer contracts and troubleshooting reimbursement variances.

• Experience supporting testing, build validation, and production support activities.

Strong communication and stakeholder management skills.

Certifications:

• Active Epic Resolute Hospital Billing (HB) Certification

• Active Epic Resolute Professional Billing (PB) Certification

HB/PB Reimbursement Contracts Certification (Preferred) Nice to Haves:

• Epic Resolute HB Reimbursement Contracts Certification.

• Epic Resolute PB Reimbursement Contracts Certification.

• Experience with Alexandria reporting.

• Medicare, Medicaid, and Commercial payer contract experience.

• Single Billing Office (SBO) Certification.

• Claims & Remittance or Charge Router Certifications.

Experience supporting large healthcare systems or enterprise revenue cycle teams.