Role Description
We are seeking an experienced Epic Patient Access Analyst specializing in Real-Time Eligibility (RTE) to support the optimization of patient access, scheduling, registration, and insurance eligibility workflows for a healthcare organization. The ideal candidate will be actively certified in Epic Cadence, Prelude, and Real-Time Eligibility and have hands-on experience configuring, maintaining, troubleshooting, and optimizing RTE functionality.
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Design, configure, test, implement, maintain, and optimize Epic Cadence, Prelude, and Real-Time Eligibility functionality.
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Evaluate existing patient access, scheduling, registration, and eligibility workflows to identify opportunities for improvement.
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Configure and maintain RTE connections, insurance plan mappings, response handling, eligibility rules, and related system settings.
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Troubleshoot eligibility transaction errors, payer response issues, plan mapping problems, and registration workflow concerns.
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Analyze RTE response data and help operational teams address coverage discrepancies, missing information, and insurance verification exceptions.
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Support front-end revenue cycle workflows involving patient registration, demographic verification, insurance coverage, benefits verification, and financial clearance.
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Configure and optimize patient access workqueues, rules, filters, routing logic, and follow-up workflows.
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Support Cadence functionality including visit types, provider templates, appointment requests, scheduling rules, decision trees, and department configuration.
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Support Prelude functionality including patient registration, demographics, coverage entry, registration rules, warnings, and account-related workflows.
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Partner with patient access, registration, scheduling, financial clearance, revenue cycle, and technical teams to gather and document requirements.
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Translate business and operational requirements into functional specifications and Epic system configuration.
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Review current-state workflows and design future-state solutions aligned with operational goals and Epic-supported functionality.
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Develop and execute unit, integrated, regression, and user acceptance testing.
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Create test scripts, document results, track defects, and coordinate issue resolution.
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Troubleshoot and resolve production incidents, service requests, enhancement requests, and application issues.
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Assist with Epic upgrades, application updates, optimization initiatives, and change-control activities.
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Monitor the impact of system changes and recommend further improvements based on workflow performance and user feedback.
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Maintain build documentation, workflow diagrams, testing materials, issue logs, and operational procedures.
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Provide knowledge transfer and application guidance to internal analysts, operational leaders, and end users.
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Communicate project progress, risks, dependencies, and recommended solutions to technical and non-technical stakeholders.
Qualifications
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Active Epic Cadence certification.
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Active Epic Prelude certification.
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Active Epic Real-Time Eligibility certification.
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Hands-on experience supporting and configuring Epic Real-Time Eligibility.
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Prior experience leading or supporting Epic optimization initiatives.
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Experience with Epic application build, configuration, testing, implementation, maintenance, and production support.
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Strong understanding of patient access, scheduling, registration, insurance eligibility, benefits verification, and financial clearance workflows.
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Experience configuring or maintaining RTE connections, payer responses, insurance plan mapping, eligibility rules, and exception workflows.
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Experience building and optimizing patient access workqueues, rules, filters, and routing logic.
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Experience analyzing current-state workflows and implementing improved future-state solutions.
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Experience gathering operational requirements and translating them into functional system solutions.
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Experience developing and executing unit, integrated, regression, and user acceptance testing.
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Strong analytical, troubleshooting, documentation, and problem-solving skills.
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Ability to collaborate effectively with patient access, revenue cycle, operational, technical, and application teams.
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Excellent written and verbal communication skills.
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Ability to work independently and manage multiple priorities in a fast-paced healthcare IT environment.
Preferred Qualifications
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Additional Epic certification or demonstrated experience in Welcome, Referrals and Authorization, Grand Central, MyChart, or Resolute.
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Experience optimizing registration quality, insurance verification, eligibility response handling, or patient financial clearance workflows.
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Experience with coverage validation, benefits review, registration error resolution, and front-end revenue cycle workqueues.
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Experience configuring Benefits Engine functionality or related patient access workflows.
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Experience supporting large-scale Epic implementations, upgrades, system restoration projects, or enterprise optimization initiatives.
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Experience working with operational leaders to measure workflow effectiveness and improve end-user adoption.
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Experience supporting pediatric, academic, or large multi-facility healthcare environments.
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Familiarity with payer integrations, electronic eligibility transactions, and third-party eligibility vendors.
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Knowledge of ServiceNow, Jira, or similar ticketing and project management tools.
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Bachelorβs degree in Information Technology, Health Informatics, Healthcare Administration, Business, or a related field, or an equivalent combination of education and experience.
Benefits
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Competitive salary and benefits package.
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Opportunity to work in a collaborative and innovative environment.
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Professional development opportunities to advance your career.
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Flexible work arrangements to promote work-life balance.