[Hiring] Senior Epic Analyst - Real-Time Eligibility @the Organization

Role Description

We are seeking an experienced Senior Epic Real-Time Eligibility (RTE) Analyst to serve as a trusted advisor and technical resource for healthcare organizations seeking to optimize insurance eligibility verification, coverage discovery, and patient access workflows within Epic.

• This position focuses on Epic RTE build, workflow optimization, system enhancements, issue resolution, and ongoing support of patient access and revenue cycle operations.
• The ideal candidate will possess deep expertise in eligibility verification processes, payer transactions, and Epic Patient Access applications.
• Responsibilities include improving financial clearance, reducing claim denials, and enhancing the patient experience.

Essential Responsibilities

• Epic RTE Support & Optimization
  • Analyze, design, configure, test, and support Epic Real-Time Eligibility (RTE) application build and enhancements.
  • Evaluate current eligibility verification workflows and identify opportunities to improve insurance validation, payer connectivity, and registration efficiency.
  • Serve as the lead analyst for RTE-related issues, optimization initiatives, and enhancement requests.
  • Develop recommendations that align Epic functionality with Patient Access and Revenue Cycle best practices.
  • Partner with operational and technical stakeholders to implement workflow improvements and system enhancements.
  • Configure and optimize eligibility response rules, payer mappings, coverage verification workflows, and exception handling processes.
  • Support initiatives focused on improving first-pass claim acceptance, reducing registration errors, and minimizing denied claims caused by eligibility issues.
• System Build, Testing & Change Management
  • Perform Epic build and configuration activities following established change control processes.
  • Create and maintain workflow documentation, build specifications, and decision documents.
  • Participate in integrated testing, user acceptance testing (UAT), upgrades, and implementation activities.
  • Troubleshoot application issues and coordinate resolutions with internal teams, payers, clearinghouses, and Epic resources.
  • Manage support tickets and prioritize issue resolution to meet client expectations.
• Client Engagement & Consulting
  • Act as a subject matter expert for Epic RTE and eligibility verification workflows.
  • Facilitate requirements gathering sessions and stakeholder meetings.
  • Communicate project status, recommendations, and system impacts to client leadership and operational teams.
  • Educate end users and leadership on Epic best practices and system functionality.
  • Support implementation, optimization, and continuous improvement initiatives.
  • Collaborate with Patient Access, Revenue Cycle, Registration, Financial Clearance, and Authorization teams to improve front-end revenue cycle performance.

Qualifications

• Active Epic Real-Time Eligibility (RTE) Certification or Epic certification supporting RTE functionality (verification required).
• Minimum 4 years of recent Epic RTE experience.
• Hands-on Epic build, support, optimization, and enhancement experience.
• Strong understanding of patient access and insurance verification workflows, including:
  • Real-Time Eligibility (RTE)
  • Insurance Verification
  • Coverage Discovery
  • Registration Workflows
  • Financial Clearance
  • Benefit Validation
  • Payer Connectivity
  • Authorization Readiness
• Experience gathering business requirements and translating operational needs into Epic solutions.
• Strong analytical, problem-solving, and troubleshooting skills.
• Excellent communication and interpersonal skills with proven client-facing experience.
• Ability to work independently while managing multiple priorities and deliverables.
• Ability to travel approximately 25% (typically one week per month, based on client needs).

Nice to Have Qualifications

• Epic Prelude Administration Certification
• Epic Cadence Administration Certification
• Epic Referral Administration Certification
• Epic MyChart Administration Certification
• Experience with eligibility clearinghouses such as Experian, Availity, Change Healthcare, or Waystar
• Epic implementation and optimization experience
• Experience with denial prevention and revenue cycle improvement initiatives
• Experience working with healthcare operational leadership and cross-functional teams
• Consulting experience supporting multiple healthcare organizations

Success in This Role

• Demonstrate deep expertise in Epic Real-Time Eligibility and insurance verification workflows.
• Identify opportunities to improve eligibility accuracy, coverage verification, and front-end revenue cycle performance.
• Build strong relationships with client stakeholders through effective communication and collaboration.
• Deliver scalable solutions that improve registration accuracy, payer verification success rates, financial clearance efficiency, and claim acceptance.
• Support healthcare organizations through ongoing optimization efforts, upgrades, and Epic initiatives.
• Help clients improve key revenue cycle metrics, including eligibility verification rates, clean claims performance, denial prevention, insurance accuracy, and patient financial clearance outcomes.

Hiring Process

• Initial interview (30-45 minutes)
• Panel interview with 3-4 team members
• Comprehensive background screening process