EPIC Solution Design Consultant
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Job Location:
Pleasanton, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
Job Title: EPIC Solution Design Consultant
Location: Pleasanton CA
Key Responsibilities
- System Architecture & Design: Lead the design and architecture of the Epic Claims modules including Resolute Professional Billing (PB) and Hospital Billing (HB) focusing on claims billing and accounts receivable workflows.
- Implementation & Configuration: Plan configure test and implement Epic software updates and new functionality translating complex business requirements into practical system solutions.
- Workflow Analysis & Optimization: Collaborate with clinical and administrative leadership to perform workflow analysis identify areas for improvement and optimize system use to enhance efficiency and ensure regulatory compliance.
- Integration Management: Design and manage integrations between Epic and third-party systems related to claims submission payment processing and other financial operations.
- Analyze business requirements and translate them into scalable secure and compliant solution designs for healthcare and insurance domains.
- Configure and optimize EPIC system workflows to support health insurance processes including eligibility claims management billing and prior authorization.
- Ensure interoperability between EPIC modules and external payer systems utilizing standards such as HL7 FHIR and EDI for robust data exchange.
- Collaborate with business analysts project managers and technical teams to validate requirements and design effective solutions.
- Facilitate workshops with clinical administrative and payer stakeholders to gather insights and continuously improve workflows.
- Configure EPIC modules (e.g. Tapestry Resolute Benefits Engine) for insurance-related functionalities and support integration strategies for claims processing eligibility verification and premium billing.
- Provide expert guidance on HIPAA compliance and data security best practices throughout solution design and implementation.
- Develop comprehensive solution design documentation including data flow diagrams and integration specifications maintaining compliance with organizational architecture standards and regulatory requirements.
- Act as a subject matter expert for troubleshooting and optimization leading detailed design efforts and workflow planning within project squads.
- Translate complex business requirements into clear actionable technical specifications and contribute to user story creation ensuring acceptance criteria are well-defined.
- Develop and maintain design documentation updating regularly throughout the project lifecycle to ensure accuracy and completeness.
- Collaborate with technical SMEs to provide necessary details for successful completion of development stories.
- Lead design and technical discussions across squads and teams to ensure alignment integration and successful project outcomes.
- Partner with Product Managers and Scrum Masters for sprint and Program Increment (PI) planning and work closely with other squads to define feature strategies for projects and initiatives.
- Experience: 5 years of experience working with EPIC systems in an analyst or architect capacity within a healthcare setting
- Epic Certification: Active Epic certification(s) in relevant Revenue Cycle modules (e.g. Resolute PB Resolute HB Claims Tapestry) is required.
- Technical Skills: In-depth knowledge of healthcare revenue cycle operations electronic claims processing standards (e.g. EDI specific claim forms) system integration standards such as HL7 & FHIR and system configuration. Strong analytical and problem-solving skills are essential
Key Skills
- Marketing
- Business Process
- Customer Service
- Communications
- Cloud
- Products demonstration
- C#
- Database
- CRM
- Project Management
- Client Relationship
- Interpersonal skills
- Sales goal
- Sales Process
- Analytics
