Senior Epic Applications Analyst - Professional Billing and Claims

Delta Dental is seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, Claims and Remittance modules to join our dynamic team. This Epic Applications Analyst plays a critical role in the implementation and installation of Epic applications, module upgrades, new components, and modifications. This position is responsible for workflow configurations, go-live support, and ongoing client support. This position is a senior role in Epic Practice Management system products. As an Application Analyst, you will collaborate with cross-functional teams, analyze business processes, and implement solutions to enhance the efficiency and effectiveness of our Epic applications.

Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones. This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes:

• Competitive base and incentive pay
• 401(k) with robust matching and non-matching contributions
• Rich medical & pharmacy benefits
• 100% employer-paid dental and vision benefits
• Holistic wellbeing program with deep financial incentives
• Generous paid time off plus 12 paid holidays and your birthday off
• Culture of growth and learning: career development; tuition reimbursement; recognition program
• Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
• Social responsibility and volunteer opportunities
• Employee discount program

Fair Chance Ordinances and Criminal Background Considerations

This position requires that the applicant undergo a background check. Qualified applicants with arrest or conviction records will be considered for employment in accordance with any applicable federal, state or local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance, the City of Los Angeles Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and/or New York Corrections Law Article 23-A.

#LI-Hybrid

• 4+ years of experience w/Bachelor's degree
• 5+ years of experience as an Epic Application Analyst strongly preferred
• Strong analytical and problem-solving skills
• Required certifications: Epic Resolute PB and Claims
• Experience in business analysis in a technical environment, supporting large teams of business, IT staff, and executive management
• Experience with both process and data-driven structured analysis techniques
• Experience with healthcare information systems in a clinical setting is a plus
• Excellent communication, influence, presentation, team and interpersonal skills; able to present goals, project scope, and requirements to any level in the organization
• Ability to conceptualize business problems and out of the box solutions
• Champion of change, process and best practices to both the business and technical team members
• Ability to train, lead and mentor others by lending subject matter expertise and knowledge
• Strong multi-tasking abilities with project management skills
• Strong data interpretation skills to form actionable suggestions to support business requirements
• Ability to understand stakeholder needs and demonstrates creative thinking to provide innovative solutions and recommend system and process enhancements
• Strong decision-making skills and process management to ensure stakeholders understand all the conditions, environment, and measures in which the decision will be made
• Ability to perform evaluation of historical trends to provide predictive insights
• Ability to offer solutions to resolve risks, conflicts, and assumptions
• Ability to summarize requirements and connect requirements to business goals while anticipating impact on target as well as related systems.
• Strong research skills/ability to get an overview and dive into details independently.
• Moderate experience with agile methodologies (with Kanban boards or Sprints)
• Strong root cause analysis skills and ability to write and execute basic SQL queries and reports
• Deep level of understanding of multiple systems

Base Pay Information

The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity.

Pay Grade 21. $80,500 - $174,300

• Epic Resolute Implementation and Support: Lead the implementation and configuration of Epic Resolute, collaborating with stakeholders to understand billing and revenue cycle management requirements. Support existing clinic/s billing and claims workflows. Customize and optimize Resolute workflows to ensure accurate and efficient financial transactions.
• Claims and Remittance Management: Design and Build the Claims and Remittance processes within the Epic system, ensuring timely and accurate submission and processing of claims. Analyze and optimize workflows related to claims adjudication and remittance processing.
• Integration and Interoperability: Collaborate with other IT teams to integrate Epic Resolute and Claims/Remittance modules with other healthcare information systems. Implement and test interfaces to enhance data exchange and interoperability, ensuring seamless connectivity with external payers and clearinghouses.
• User Support and Training: Provide user support for Epic Resolute, Claims, and Remittance applications, addressing queries and issues related to billing and claims processing. Develop and deliver training programs for end-users to optimize the use of Epic applications for billing and claims management.
• Continuous Improvement: Analyze system performance and user feedback to identify areas for improvement in Epic Resolute and Claims/Remittance functionalities. Proactively suggest and implement enhancements to streamline billing processes, reduce denials, and improve revenue cycle efficiency.
• Acting as the primary support contact for the application''s end‐users.
• Identifying issues that arise in their application area as well as issues that impact other application teams, and working to resolve them.
• Guiding workflow design, building and testing the system, and analyzing other technical issues associated with Epic software.
• Identifying and implementing requested changes to the system.
• Serving as a liaison between end users'' workflow needs and Epic implementation staff.
• Maintaining regular communication with Epic representatives, including participating in weekly project team meetings.
• Working with Epic representatives, your organization''s business community and end users to ensure the system meets the organization''s business needs.
• Developing an understanding of operational needs to set the direction for the organization''s workflows by attending site visits and other integrated sessions.
• Participating in training and working with end users.
• Troubleshooting problems and questions.
• Reviewing the status of projects and issues on an ongoing basis with leadership.
• Works independently in assisting the business in building upon the project definition, description and vision document, which may include scope, risk, and identification of stakeholders with infrequent oversight.
• Plans, coordinates, and creates written documentation that clearly describes the needs of the business, which may include Business Requirements, Business Use Cases, Process Models, Business Needs Analysis, or Conceptual Design Documents.
• Gathers requirements, researches and analyzes existing and proposed solutions in the development, modification, or enhancement of programs or systems.
• Engages in dependency analysis, functional design, workflow analysis, use case analysis, data and process modeling, and has a clear understanding of the current and future business rules.
• Participates in the Testing discipline by partnering with the Test Lead to support including Test Planning, incident research and analysis, Test strategy, QA and user acceptance testing functions, as needed.
• Leverages a deep understanding of system behavior and data properties to assist Test Lead in determining efficient and effective approaches to testing broad and/or complex topics.
• Works independently to prepare and plan all aspects of the Requirements discipline, including controlling or participating in estimating, feasibility analysis, meeting facilitation, management and executive reporting, change request management, issue tracking, process improvements, and project planning.
• Provides support as needed throughout the project lifecycle, participating directly in issue resolution, break and hot fix support, and triage in the identification and resolution of all project incidents, documentation maintenance and traceability as related to the Requirements discipline.
• Stays current with customer needs and strategies; Utilizes formal and informal written communication methods to communicate updates and findings; Facilitates meetings and presentations to all types of diverse audiences.
• Epic Resolute Implementation and Support: Lead the implementation and configuration of Epic Resolute, collaborating with stakeholders to understand billing and revenue cycle management requirements. Support existing clinic/s billing and claims workflows. Customize and optimize Resolute workflows to ensure accurate and efficient financial transactions.
• Claims and Remittance Management: Design and Build the Claims and Remittance processes within the Epic system, ensuring timely and accurate submission and processing of claims. Analyze and optimize workflows related to claims adjudication and remittance processing.
• Integration and Interoperability: Collaborate with other IT teams to integrate Epic Resolute and Claims/Remittance modules with other healthcare information systems. Implement and test interfaces to enhance data exchange and interoperability, ensuring seamless connectivity with external payers and clearinghouses.
• User Support and Training: Provide user support for Epic Resolute, Claims, and Remittance applications, addressing queries and issues related to billing and claims processing. Develop and deliver training programs for end-users to optimize the use of Epic applications for billing and claims management.
• Continuous Improvement: Analyze system performance and user feedback to identify areas for improvement in Epic Resolute and Claims/Remittance functionalities. Proactively suggest and implement enhancements to streamline billing processes, reduce denials, and improve revenue cycle efficiency.
• Acting as the primary support contact for the application''s end‐users.
• Identifying issues that arise in their application area as well as issues that impact other application teams, and working to resolve them.
• Guiding workflow design, building and testing the system, and analyzing other technical issues associated with Epic software.
• Identifying and implementing requested changes to the system.
• Serving as a liaison between end users'' workflow needs and Epic implementation staff.
• Maintaining regular communication with Epic representatives, including participating in weekly project team meetings.
• Working with Epic representatives, your organization''s business community and end users to ensure the system meets the organization''s business needs.
• Developing an understanding of operational needs to set the direction for the organization''s workflows by attending site visits and other integrated sessions.
• Participating in training and working with end users.
• Troubleshooting problems and questions.
• Reviewing the status of projects and issues on an ongoing basis with leadership.
• Works independently in assisting the business in building upon the project definition, description and vision document, which may include scope, risk, and identification of stakeholders with infrequent oversight.
• Plans, coordinates, and creates written documentation that clearly describes the needs of the business, which may include Business Requirements, Business Use Cases, Process Models, Business Needs Analysis, or Conceptual Design Documents.
• Gathers requirements, researches and analyzes existing and proposed solutions in the development, modification, or enhancement of programs or systems.
• Engages in dependency analysis, functional design, workflow analysis, use case analysis, data and process modeling, and has a clear understanding of the current and future business rules.
• Participates in the Testing discipline by partnering with the Test Lead to support including Test Planning, incident research and analysis, Test strategy, QA and user acceptance testing functions, as needed.
• Leverages a deep understanding of system behavior and data properties to assist Test Lead in determining efficient and effective approaches to testing broad and/or complex topics.
• Works independently to prepare and plan all aspects of the Requirements discipline, including controlling or participating in estimating, feasibility analysis, meeting facilitation, management and executive reporting, change request management, issue tracking, process improvements, and project planning.
• Provides support as needed throughout the project lifecycle, participating directly in issue resolution, break and hot fix support, and triage in the identification and resolution of all project incidents, documentation maintenance and traceability as related to the Requirements discipline.
• Stays current with customer needs and strategies; Utilizes formal and informal written communication methods to communicate updates and findings; Facilitates meetings and presentations to all types of diverse audiences.