Patient Benefits Analyst

Senior Revenue Cycle Analyst – Epic PB SME

Position Overview

We are seeking an experienced Senior Revenue Cycle Analyst (SME) with extensive expertise in Epic Professional Billing (PB), insurance benefit interpretation, and third-party coverage discovery. This individual will serve as a subject matter expert supporting revenue cycle operations by optimizing coverage discovery processes, improving patient responsibility collections, and providing strategic recommendations to enhance revenue performance.

The ideal candidate is analytical, detail-oriented, and highly knowledgeable in revenue cycle reporting, claims adjudication, and Epic workflows.

Key Responsibilities

• Review coverage discovery for scheduled patient appointments to accurately determine patient financial responsibility.
• Document insurance coverage information appropriately within Epic.
• Analyze trends related to coverage discovery and point-of-service patient responsibility collections across multiple clinic locations.
• Identify opportunities for process improvement and recommend strategies to optimize patient responsibility collections and third-party reimbursement.
• Partner with clinical and operational leadership on coverage discovery, patient responsibility, and revenue cycle initiatives.
• Interpret insurance benefits and eligibility information to support accurate billing and collections processes.
• Provide subject matter expertise on revenue cycle reporting, system build, workflows, logic, and claims adjudication.
• Support data analysis, training initiatives, and process documentation related to revenue cycle operations.
• Collaborate with internal teams and external clearinghouses to resolve coverage and reimbursement issues.
• Develop and maintain best practices that improve operational efficiency and financial outcomes.

Required Qualifications

• 7+ years of experience as a Revenue Cycle Subject Matter Expert (SME).
• Extensive experience with Epic Professional Billing (PB); Epic certification strongly preferred.
• RHIA, RHIT, or CPC certification required.
• Advanced knowledge of:
• • Revenue cycle operations and workflows
  • Claims adjudication and reimbursement processes
  • Revenue cycle reporting, data analysis, and system logic
  • Third-party coverage discovery
  • Insurance benefit interpretation
  • Real-Time Eligibility (RTE) interpretation
  • Clearinghouse processes and integrations
• Experience developing and delivering training related to revenue cycle systems and workflows.
• Strong analytical and problem-solving skills with the ability to identify trends and recommend process improvements.
• Excellent communication and presentation skills with the ability to collaborate effectively with leadership and cross-functional teams.

Preferred Qualifications

• Epic PB Certification.
• Experience supporting large, multi-site healthcare organizations.
• Experience with revenue cycle system build and workflow optimization initiatives.

Desired Skills

• Revenue Cycle Operations
• Epic Professional Billing (PB)
• Insurance Eligibility & Benefit Interpretation
• Coverage Discovery
• Claims Adjudication
• Data Analysis & Reporting
• Clearinghouse Management
• Process Improvement & Optimization
• Training & Documentation
• Leadership Communication & Stakeholder Management

This role is ideal for a revenue cycle professional who enjoys solving complex reimbursement challenges, leveraging data to drive improvements, and serving as a trusted subject matter expert in healthcare revenue cycle operations.