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Remittance and PLB Applications Analyst

Remote: 
Full Remote
Contract: 
Full time
Experience: 
Senior (5-10 years)
Work from: 
Florida (USA), United States

Offer summary

Qualifications:

High School Diploma required, Minimum of 5 years' experience in healthcare or business office, EPIC Certification needed within 6 months, Understanding of claims revenue cycle, Critical thinking skills for Epic applications.

Key responsabilities:

  • Support CBO and affiliates with electronic remittance programming functions
  • Maintain, update, and correct remittance setups in Epic applications
  • Create and manage Remittance Options and workqueues
  • Assist with remittance and PLB related issues via HelpDesk
  • Collaborate with internal departments and external partners for workflow improvements
Nemours logo
Nemours XLarge https://www.nemours.org/
5001 - 10000 Employees
About Nemours
Nemours is committed to improving the health of children. As a non-profit children’s health organization, we consider the health of every child to be a sacred trust.Through family-centered care in our children’s hospitals and clinics in Delaware, New Jersey, Pennsylvania and Florida, as well as world-changing research, education and advocacy, Nemours fulfills the promise of a healthier tomorrow for all children — even those who may never enter our doors.Nemours began more than 80 years ago with the vision of Alfred I. duPont to improve the lives of children and to do whatever it takes to prevent and treat even the most disabling childhood conditions.Today, through our children’s hospitals and health system, we directly care for 250,000 children annually in Delaware Valley and Florida, including families who travel from across the country and world to see our specialists — treating every child as we would our own.We also reach beyond the walls of our hospitals and clinics to be a voice for children on a national and international level, and to lead the way in prevention, intervention, education, and research.Nemours is growing to better serve the children and families in our care. We have 1.1 million square feet of space currently devoted to providing children’s healthcare or under construction, all designed with significant input and advice from our patients and families.
See more Nemours offers

Job description

Nemours is seeking a Remittance and PLB Applications Analyst (Full-Time), to join our team in Jacksonville, Florida.

This is a remote position.

This position is responsible for working with the CBO Revenue Cycle Applications Manager to provide direct support to the Central Business Office (CBO) and other Nemours affiliates by ensuring all professional and hospital electronic remittance programming functions are accurate. This includes, but is not limited to, maintaining, updating, and correcting the PB/HB Remittance setup within the Epic Hyperspace and Resolute Text applications, testing and validating all system build and new release functionality, maintaining the electronic remittance options (RMOs) and related items that pertain to remittance. This position is also responsible for ensuring other Resolute Master Files are set up to correctly support remittance and PLBs. Works with CBO representatives and leadership and other internal departments to perform reviews and analyses of workflows, data collection, report details and other technical issues associated with Epic Resolute Remittance applications.

The Remittance and PLB Applications Analyst should have the ability to recognize opportunities for process improvement and optimization activities designed to create more knowledgeable end users. The role of this position includes acting as a change agent, educator, and resource in advancing the strategic mission of Nemours.
  • Assist Central Business Office associates, end users, and leadership with Remittance and PLB related issues via HelpDesk tickets and/or remittance projects with the goal of increasing prompt and accurate electronic payment posting including PLBs.
  • Create and maintain Remittance Options (RMOs) for use in electronic remittance posting as well as the custom programming and rules for RMOs
  • Create, maintain, monitor, and when appropriate, resolve issues in Remittance workqueues.
  • Create, maintain, monitor and when appropriate, resolves issues with PLB clearing accounts
  • Work with clearinghouse and other partners to ensure accurate 835 files transmission
  • Work with Nemours Health Informatics and IS Departments for remittance setup, troubleshooting, and workflows.
  • Work with assigned Epic Technical Support on Epic support log tickets, custom changes/fixes, Release Notes, and Epic upgrades.
  • Participate in the evaluation, testing and validation of new release and upgrade functionality.
  • Attends scheduled huddles and meetings to discuss team and project related activities, issues, changes, communications, and updates.
  • Have the ability to work independently and meet project guidelines/timelines.
  • Other duties as assigned.
Requirements:
  • High School Diploma required.
  • Minimum of one (5) years' experience in a healthcare related field, business office, or managed care setting required.
  • Professional and/or Hospital Billing Claims and Remittance Administration EPIC Certification (or completion within 6 months of hire date).
  • Understanding of the claim's revenue cycle, including but not limited to, standard billing procedures (NUCC, NUBC and ANSI), payments/denials by commercial and Medicaid health insurers.
  • Able to apply critical thinking skills to building and testing of Epic applications.

Required profile

Experience

Level of experience: Senior (5-10 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Revenue Cycle ManagementProcess ImprovementData AnalysisMedical BillingEpic ResoluteClaims ProcessingProject CollaborationBilling

Other Skills

  • Verbal Communication Skills
  • Problem Solving
  • Time Management
  • Critical Thinking
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