Experienced technical specialist responsible for building, testing, and supporting the Epic Professional Billing (PB) system to enable accurate and compliant billing operations across Quest Diagnostics.
This role independently manages complex configuration assignments, analyzes billing requirements, develops system solutions, improves workflows that support clean claims, timely payments, and overall billing efficiency. The Analyst III works collaboratively with leadership and cross-functional teams to maintain billing integrity, reduce manual work, and enhance the end-user experience for billing staff, providers, and patients by improving workflow efficiency and overall usability.
Key responsibilities
- Configure and maintain Epic PB and/or PB Claims system components, including charge router logic, billing work queues, claim edit rules, and remittance processing.
- Translate complex billing requirements into accurate Epic configurations that support business needs.
- Participate in build reviews to ensure compliance with technical standards and governance requirements.
- Update payer-specific logic, provider mapping, and fee schedules to maintain accurate billing data.
- Document configuration steps and maintain organized, auditable change records.
- Troubleshoot high-complexity issues impacting charge capture, claims, or payment posting.
- Perform data analysis using system logs, error queues, and root cause tracking tools.
- Identify trends in recurring system or process issues and propose corrective actions.
- Collaborate with Revenue Cycle Operations, Technology, and clearinghouse partners to resolve interface or claim submission discrepancies.
- Escalate unresolved technical issues with supporting documentation to the Technical Lead or Epic Representative.
- Plan and execute detailed test scenarios for new configurations, upgrades, and enhancements.
- Validate end-to-end workflows for accuracy of charge capture, claim generation, and remittance posting.
- Conduct regression testing to confirm that new changes do not negatively impact production workflows.
- Partner with business users to confirm functional accuracy and ensure strong operational adoption.
- Monitor assigned billing work queues and proactively identify build or workflow improvements.
- Evaluate automation opportunities and participate in initiatives to streamline manual processes.
- Provide clear documentation and job aids for billing teams to support consistent system usage.
- Contribute to post-deployment review sessions to confirm expected outcomes and user satisfaction.
- Serve as a subject resource for Epic PB functionality within the application support team.
- Share technical findings and lessons learned through team documentation and internal training sessions.
- Collaborate closely with Claims and Bridges teams to maintain integrated data flow across Epic modules.
- Participate in project meetings to provide technical insight, system validation, and issue tracking.
Required qualifications
- 5+ years of experience supporting and configuring Epic Resolute Professional Billing (PB).
- Demonstrated understanding of Epic charge router, claims, remittance, and reconciliation workflows.
- Proven ability to analyze system data and translate findings into precise configuration adjustments.
- Strong technical documentation and problem-solving skills.
- Ability to work independently on multiple assignments and manage competing priorities.
- Strong understanding of healthcare billing, payer requirements, and denial management.
- Bachelor's degree in Healthcare, Business, or Information Systems, or equivalent work experience.
- Advanced Epic PB training and participation in continuous optimization and upgrade programs.
- Epic Resolute Professional Billing certification or Claims certification.
- English required.
- Travel up to 5%.
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 month ago