Epic Resolute Billing Analyst IV

Job Description

The Epic Resolute Professional Billing Analyst IV is a technical lead, responsible for the design, configuration, maintenance, and troubleshooting of the Epic Professional Billing (PB) system.  This role leads the technical execution of complex billing workflows spanning charge capture, claims generation, remittance posting and payment reconciliation to ensure system accuracy, reliability and compliance across Quest’s operations.

As the top technical resource on the Professional Billing team the technical lead works closely with analysts, finance, and technology partners to resolve high impact issues, drive system improvements, and ensure an exceptional end user experience for billing and revenue staff.  The role emphasizes technical precision, workflow optimization and consistent system performance enabling Quest’s billing teams to operate efficiently and deliver accurate, timely billing outcomes for patients, providers and clients.

Responsibilities:

• Perform advanced Epic PB build, including charge router rules, billing work queues, claims edits, remittance posting, and payment plan configuration.
• Configure and maintain fee schedules, charge capture logic, provider mappings, and payer-specific billing rules.
• Implement and validate cross-module workflows involving Charge Router, Claims, SBO, and HIM.
• Lead system build reviews and peer validation to ensure configuration consistency and adherence to Quest standards.
• Coordinate migration of build changes across development, test, and production environments using Data Courier and established change control processes.
• Serve as the top escalation point for complex Epic PB issues affecting charge capture, claims generation, or payment posting.
• Diagnose and resolve technical and data-related issues between Epic PB and external systems.
• Analyze error queues, logs, and data flows to determine root causes and implement permanent solutions.
• Partner with Epic Bridges, Clarity, and infrastructure teams to address system dependencies, performance issues, and interface problems.
• Document findings, corrective actions, and solutions to support long-term knowledge management.
• Lead technical testing efforts for PB-related upgrades, patches, and version releases.
• Develop and maintain detailed regression testing plans, test scripts, and validation documentation.
• Execute end-to-end testing across integrated systems (Charge Router, SBO, Claims, and clearinghouse interfaces).
• Collaborate with QA and operations teams to track, resolve, and retest defects before deployment.
• Oversee production validation during go-live and post-implementation monitoring.
• Monitor PB system performance, error queues, and automation rules to identify opportunities for improvement.
• Evaluate claims edits, billing rules, and charge routing for efficiency and compliance.
• Recommend system adjustments to reduce manual intervention and improve end-user productivity.
• Maintain comprehensive documentation for all PB configurations, workflows, and data dependencies.
• Provide day-to-day technical guidance, code review, and mentoring for Epic PB Analysts I–III.
• Lead technical workstreams, delegate tasks, track progress, and ensure high-quality deliverables.
• Collaborate with Finance, Revenue Cycle Operations, Compliance, and IT teams to align system build with operational goals.
• Serve as a subject matter expert for Epic PB integrations and cross-functional dependencies.
• Promote best practices in build, testing, and change management to ensure long-term stability and user satisfaction.

Qualifications:

Required:

• 7+ years of experience configuring and supporting Epic Resolute Professional Billing (PB) applications.
• Deep knowledge of charge capture, charge router logic, claims generation, payment posting, and reconciliation workflows.
• Proven ability to resolve complex technical and data issues within large enterprise environments.
• Experience leading system testing, code migrations, and post-deployment validations.
• Strong documentation, analytical, and problem-solving skills.
• Demonstrated experience mentoring and leading technical project teams.
• Continuing education in healthcare billing systems, automation and integration technologies

Preferred:

• Experience working in a national or multi-site reference laboratory billing environment.
• Familiarity with Epic Bridges, Single Billing Office (SBO), and Claims modules.
• Understanding of payer contracts, billing regulations, and reimbursement methodologies.
• Experience with SQL, Epic Clarity, or revenue cycle analytics tools.
• Epic SBO, Charge Router, or Claims certification
• Additional Epic or technical certifications related to revenue cycle or integration

Education

• Bachelor’s degree in Healthcare, Business, or Information Systems or the equivalent work experience.

Certification

• Epic Resolute Professional Billing certification

Work Requirements

• Travel required up to 25%. Required travel is about one week a month.

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Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Vets or any other legally protected status.