IT Professional Billing Analyst

Position Overview

The position requires technical and programming expertise with IBM I-Series/AS400, to support and enhance billing and integration operations. Responsible for owning, managing, and optimizing the professional billing functionality within Capital Health's electronic medical record (EMR) system. This role serves as a liaison between clinical, revenue cycle, IT, and operational teams to ensure accurate billing, compliance, and workflow efficiency.

MINIMUM REQUIREMENTS

Education:

• Bachelor's degree in healthcare administration, business, information systems, or related field (or equivalent experience).

Experience:

• Working with IBM i-Series/AS400 providing technical and application support.
• Three years of experience in healthcare revenue cycle, billing, or EMR system support.
• Hands-on experience with EMR professional billing modules (Epic PB, Cerner, Athena, Allscripts, etc.).

Other Credentials:

Knowledge and Skills:

• Strong analytical, problem-solving, and documentation skills.
• Ability to translate business requirements into technical solutions.
• Experience with SQL, report writing tools, and data extracts.
• Knowledge of RPG, RPGILE, CLP, SDA, SQL, and EDI.
• Familiarity with OpenText EDI and Rocket Software GUI for screen design.
• Excellent communication and stakeholder management skills.

Special Training:

• Experience with healthcare billing compliance requirements (CMS, HIPAA, payer rules). (Preferred)

ESSENTIAL FUNCTIONS:

• Utilize RPG, RPGILE, CLP, SDA, SQL, and EDI for billing and reporting.
• Serve as the subject matter expert (SME) for professional billing modules within the EMR.
• Analyze, configure, and maintain billing workflows, charge capture, claim generation, and posting processes.
• Collaborate with clinicians, coding teams, and revenue cycle staff to ensure accurate charge entry and reconciliation.
• Partner with IT and EMR vendors to manage upgrades, enhancements, and system fixes related to billing.
• Conduct requirements gathering, process mapping, and gap analysis for billing workflows.
• Document functional specifications for system enhancements and lead testing/validation.
• Provide end-user training, support, and job aids for billing system users.
• Troubleshoot billing-related issues, escalate to vendors when required, and ensure timely resolution.
• Support audits, compliance reviews, and remediation for billing discrepancies.
• Provide reporting and analytics on billing performance, denials, and revenue cycle KPIs.
• Support programming and technical functions including database operations, report writing, and screen design.
• Manage system integrations using OpenText EDI and Rocket Software GUI design.
• Perform other duties as assigned.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities

Continuous physical demands include: Sitting , Keyboard use/repetitive motion

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Accurate Hearing

Anticipated Occupational Exposure Risks Include the following: Uneven Surfaces or Elevations

Benefits

This position is eligible for the following benefits:

• Medical Plan
• Prescription drug coverage & In-House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
  • Healthcare FSA
  • Dependent Care FSA
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
  • Voluntary Life Spouse
  • Voluntary Life Employee
  • Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time-Off Program