Provide subject matter expertise for Epic Revenue Cycle claims workflows, including claims generation, edits, reconciliation, splitting, billing, denials, and resolution. Analyze and optimize processes, troubleshoot issues, translate operational needs into system solutions, support configuration and testing, document workflows, and partner with clinical, billing, operational, and technical stakeholders. The consultant will also support implementations, go-live stabilization, revenue cycle transformation, and reimbursement optimization for a large healthcare organization.
This is a remote position.
About Us
Ellit Groups is a Private Equity-backed, woman, minority-led healthcare IT consulting firm focused on Provider and Payer organizations. We partner with healthcare leaders who value operational excellence, real-world experience, and diverse perspectives to drive better outcomes.
Our firm is built by former healthcare operators who understand the realities of running complex healthcare systems. This combination of operator credibility and investment-backed growth enables us to deliver high-impact, scalable solutions.
We differentiate ourselves by bringing practical experience, executive-level insight, and a relentless focus on quality and outcomes. Our success is directly tied to our clients’ success.
Job Summary
We are seeking an experienced Epic Revenue Cycle Claims Subject Matter Expert (SME) to support a large-scale healthcare technology initiative. This consultant will provide deep expertise in Epic Revenue Cycle claims management processes, with a particular focus on claims generation, claim edits, claim reconciliation, and complex claim splitting workflows.
The ideal candidate is a highly skilled Epic Revenue Cycle professional with extensive experience resolving claims-related challenges, optimizing claims workflows, and supporting healthcare organizations through revenue cycle transformation and operational improvement initiatives.
Assignment Details:
- Initial 6-month contract with likelihood of extensions
- Fully remote
- Immediate need for an experienced claims expert
- Opportunity to support a large healthcare organization through critical revenue cycle initiatives
- Serve as the primary subject matter expert for Epic Revenue Cycle claims workflows and processes.
- Analyze existing claims processes and identify opportunities for optimization and improved reimbursement outcomes.
- Provide expertise in complex claims management, including claim splitting, claim edits, billing workflows, and claims resolution.
- Support the design, configuration, validation, and optimization of Epic Revenue Cycle functionality related to claims processing.
- Partner with revenue cycle leadership, billing teams, operational stakeholders, and technical teams to address claims challenges and system enhancements.
- Investigate, troubleshoot, and resolve claims processing issues, denials, edits, and workflow inefficiencies.
- Review claims data, identify root causes of issues, and recommend corrective actions.
- Support testing activities, including unit testing, integrated testing, user acceptance testing, and workflow validation.
- Develop and maintain documentation for claims workflows, business requirements, configurations, and process improvements.
- Provide guidance and best practices related to claims management, reimbursement workflows, and revenue cycle operations.
- Assist with go-live support, stabilization efforts, and post-implementation optimization activities.
Requirements
Required Qualifications
- Minimum of 5 years of Epic Revenue Cycle experience.
- Extensive hands-on experience with Epic claims management and billing workflows.
- Deep expertise in claim splitting, claim edits, claims reconciliation, and claims processing operations.
- Strong understanding of healthcare reimbursement methodologies and revenue cycle best practices.
- Experience identifying and resolving denials, billing issues, and revenue cycle workflow challenges.
- Experience gathering requirements and translating operational needs into system solutions.
- Strong analytical, troubleshooting, and problem-solving skills.
- Excellent communication and stakeholder management abilities.
- Experience working with large healthcare organizations and complex revenue cycle environments.
- Epic Resolute Hospital Billing (HB) and/or Professional Billing (PB) Certification.
- Epic Claims Certification preferred.
- Experience supporting Epic implementations, upgrades, optimizations, or revenue cycle transformation initiatives.
- Experience with revenue integrity, denial management, and reimbursement optimization.
- Consulting experience preferred.
- Experience supporting enterprise healthcare systems with high claims volume.
Benefits
What We Offer:
- Competitive salary and benefits package.
- Opportunity to work in a collaborative and innovative environment.
- Professional development opportunities to advance your career.
- Flexible work arrangements to promote work-life balance.
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