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Job DescriptionJob Description:An Epic Physician Billing Analyst (also known as an Epic Professional Billing Analyst) is responsible for the configuration, maintenance, and optimization of the Epic Professional Billing module within a healthcare organization. This role is vital for ensuring accurate patient billing, claims processing, and reimbursement for services provided by individual healthcare providers, such as doctors or therapists. Key Responsibilities:System Configuration and Maintenance: Configure and customize the Epic Professional Billing application to meet the specific business needs and workflows of the organization. Maintain the Resolute Professional Billing module to manage charges, benefit engines, and workflows with external collection agencies. Perform ongoing maintenance and updates to Epic applications. Build and test system changes, presenting them to end-users and migrating them to production. Workflow Analysis and Optimization: Analyze existing financial workflows and identify opportunities for improvement and optimization. Design and implement leading practice workflows to enhance efficiency and effectiveness. Collaborate with various stakeholders, including IT, finance, and end-users, to ensure the Epic system aligns with business operations. Support and Troubleshooting: Act as the primary support contact for Epic Professional Billing application end-users. Provide support to end-users on the Epic EMR system, including integrating revenue cycle processes such as maintaining claim scrubbers and payment processors. Troubleshoot system errors and resolve issues related to billing, claims, and reimbursement. Provide on-call support on a rotating basis. Training and Education: Participate in training and educate end-users on the Epic Professional Billing application and related workflows. Develop and document internal procedures for using Epic and other applications. Compliance and Updates: Stay current with Epic technologies, obtain and maintain necessary Epic certifications. Ensure compliance with industry standards and regulations, such as transitioning between different claim formats (e.g., X12 4010 to 5010) and coding systems (e.g., ICD-9 to ICD-10). Review and assess the impact of changes and enhancements with each new Epic release and make recommendations for the best course of action. Essential skills and qualifications:Education and Certification: Bachelor’s Degree, preferably in Computer Science, Information Technology, Computer Engineering, or a related field. Certified in Epic Professional Billing. Technical Skills: Expertise in Epic's Professional Billing module, including charge router, workqueue configuration, collection agency workflows, statement processing, benefit engine, and estimates. Experience with system configuration and troubleshooting tools. Proficiency with Microsoft Office Suite (Word, Project, Excel, Visio, and PowerPoint). Healthcare Industry Knowledge: Strong understanding of healthcare revenue cycle processes, medical billing codes, and insurance procedures. Familiarity with the differences between professional billing and hospital billing. Knowledge of medical coding systems like CPT and ICD-10. Soft Skills: Strong interpersonal relationship skills and effective communication skills (both oral and written). Analytical thinking and problem-solving abilities. Attention to detail and accuracy. Self-motivated and a team player.

Job DescriptionThe work we do has an impact on millions of lives, and you can be a part of it.We help protect our customers against life’s uncertainties. Regardless of where you work within the company, you’ll be helping provide protection and peace of mind when our customers need it most. The Business Analyst will be responsible for business and functional requirements definition for various new and existing IT applications, downstream systems and reports. The business analyst will also be responsible for planning and facilitating user acceptance testing. Essential Duties/Responsibilities: • Identify and translate business needs into clearly defined requirements for insurance software applications., • Develop requirements documentation inclusive of user stories/ use cases, process flows, data flows and report mock-ups., • Plan, facilitate, and conduct requirements gathering sessions, meetings, and presentations., • Build strong relationships within the business units and support functions to understand the business needs., • Collaborate with development and testing teams to provide subject matter expertise, ensure that out of the box functionality is leveraged and to assist in troubleshooting and resolving issues., • Ensure that proposed solutions are focused on improving efficiency and effectiveness of the business processes and are consistent across products where possible., • Participate in the development and planning of the User Acceptance Testing activities, including test plans and scripts, based on requirements., • Facilitate UAT execution phase and work with business lead and project manager to obtain user acceptance test signoff., • Team player who works well with technical and business resources., • Meet objectives & goals set forth by management, • Perform additional projects/duties as assigned by management.Required Skills/Abilities/Education/Experience:, • Bachelor’s Degree or equivalent work experience in Business Analysis, • 2-4 years of experience in Business Analysis – Requirements documentation, Functional testing, Reporting tools, Relational databases, SQL., • Experience in programming is a plus., • Experience working in the Insurance/Benefits industry is a big plus., • Experience with Azure DevOps is a plus

Job DescriptionAbout The Role We are seeking a detail-oriented and proactive QA Analyst to support quality assurance efforts across Brighton Health Plan Solutions’ core portfolios—Claims, Provider, and Enrollment. In this role, you will contribute to both functional testing and automation activities, helping strengthen QA processes. You will play a key part in ensuring high-quality software delivery by validating business requirements, improving test practices, supporting limited automation initiatives, and collaborating closely with technical and business teams.Primary Responsibilities QA Strategy & Leadership • Contribute to building a consistent QA approach across multiple portfolios (Claims, Provider, Enrollment), to improve test efficiency, traceability, and quality metrics., • Assist in establishing reusable processes, documentation standards, and quality checkpoints., • Promote early testing practices and support shift-left collaboration within Agile/Scrum teams., • Support leadership in maturing QA workflows and cross-team coordinationFunctional QA & Validation, • Develop comprehensive test cases, acceptance criteria, and test data based on business and technical requirements., • Perform hands-on functional, integration, and regression testing across applications and data workflows., • Validate end-to-end business processes such as claims adjudication, provider data updates, enrollment transactions, pricing, and benefits logic., • Participate in defect triage, root-cause discussions, and timely defect escalation.Test Automation Support, • Support existing automation efforts by maintaining or executing automated tests for data loads, data validations, volume testing etc., • Contribute to creating or enhancing small-scale scripts for repetitive regression or smoke testing where automation adds value., • Leverage tools such as Selenium, Unix Shell Scripting or similar to supplement manual test coverage., • Participate in agile test execution where applicable, in collaboration with developers.Cross-Functional Collaboration, • Work closely with business analysts, developers, product owners, and external vendors to ensure quality is embedded in the development lifecycle., • Participate in team collaboration meetings, including planning, reviews, and retrospectives, as a QA voice and quality advocate., • Lead or participate in defect triage and resolution discussions, ensuring timely identification and escalation of issues., • Coordinate with external vendors or partners when validating integrated workflows or data exchanges.Documentation & Reporting, • Maintain detailed QA documentation, including test plans, automation reports, traceability matrices, and defect logs., • Provide QA KPIs and automation metrics to leadership to demonstrate test coverage, execution success, and release readiness., • Ensure consistent reporting to support release planning and stakeholder communication.Essential Qualifications, • Bachelor’s degree in Computer Science, Information Systems, Healthcare IT, or a related field., • 5+ years of experience in QA, with 1+ years in test automation in a healthcare payer environment., • Hands-on experience with automation tools such as Selenium, Postman, or similar., • Experience building test automation for Unix applications and backend databases (SQL Server)., • Proficient in one or more scripting or programming languages (e.g., Java, Python, JavaScript)., • Strong understanding of QA practices in fast-paced delivery environments., • Solid knowledge of EDI X12 transactions (834, 837, 835, 270/271), Claims, Enrollment, and Provider data workflows., • Proficient with SQL for backend testing and data validation., • Familiarity with test management tools such as JIRA or equivalent., • Excellent analytical, problem-solving, and communication skills.Preferred Qualifications, • Knowledge of version control systems like Git and test result reporting using BI Reporting, or similar., • Exposure to performance testing tools (e.g., JMeter) is a plus.* General Knowledge of HIPAA Confidentiality Laws About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities. Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions. Come be a part of the Brightest Ideas in Healthcare™. Company Mission Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners. Company Vision Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways. DEI Purpose Statement At BHPS, we encourage all team members to bring your authentic selves to work with all your unique abilities. We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace. We are building, nurturing, and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level. *We are an Equal Opportunity Employer Annual Salary Range: $ The salary range and/or hourly rate listed is a good faith determination that may be offered to a successful applicant for this position at the time of the posting of an advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable by law including but not limited to location, years of relevant experience, education, credentials, skills, budget and internal equity. JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: Powered by JazzHR ad2GI9UnkD

Job Description Job Description: • An Epic Physician Billing Analyst (also known as an Epic Professional Billing Analyst) is responsible for the configuration, maintenance, and optimization of the Epic Professional Billing module within a healthcare organization., • System Configuration and Maintenance:, • Configure and customize the Epic Professional Billing application to meet the specific business needs and workflows of the organization., • Maintain the Resolute Professional Billing module to manage charges, benefit engines, and workflows with external collection agencies., • Perform ongoing maintenance and updates to Epic applications., • Build and test system changes, presenting them to end-users and migrating them to production., • Workflow Analysis and Optimization:, • Analyze existing financial workflows and identify opportunities for improvement and optimization., • Design and implement leading practice workflows to enhance efficiency and effectiveness., • Collaborate with various stakeholders, including IT, finance, and end-users, to ensure the Epic system aligns with business operations., • Support and Troubleshooting:, • Act as the primary support contact for Epic Professional Billing application end-users., • Provide support to end-users on the Epic EMR system, including integrating revenue cycle processes such as maintaining claim scrubbers and payment processors., • Troubleshoot system errors and resolve issues related to billing, claims, and reimbursement., • Provide on-call support on a rotating basis., • Training and Education:, • Participate in training and educate end-users on the Epic Professional Billing application and related workflows., • Develop and document internal procedures for using Epic and other applications., • Compliance and Updates:, • Stay current with Epic technologies, obtain and maintain necessary Epic certifications., • Ensure compliance with industry standards and regulations, such as transitioning between different claim formats (e.g., X12 4010 to 5010) and coding systems (e.g., ICD-9 to ICD-10)., • Review and assess the impact of changes and enhancements with each new Epic release and make recommendations for the best course of action. Essential skills and qualifications: • Education and Certification:, • Bachelors Degree, preferably in Computer Science, Information Technology, Computer Engineering, or a related field., • Certified in Epic Professional Billing., • Technical Skills:, • Expertise in Epic's Professional Billing module, including charge router, work queue configuration, collection agency workflows, statement processing, benefit engine, and estimates., • Experience with system configuration and troubleshooting tools., • Proficiency with Microsoft Office Suite (Word, Project, Excel, Visio, and PowerPoint)., • Healthcare Industry Knowledge:, • Strong understanding of healthcare revenue cycle processes, medical billing codes, and insurance procedures., • Familiarity with the differences between professional billing and hospital billing., • Knowledge of medical coding systems like CPT and ICD-10., • Soft Skills:, • Strong interpersonal relationship skills and effective communication skills (both oral and written)., • Analytical thinking and problem-solving abilities., • Attention to detail and accuracy., • Self-motivated and a team player.

Job Description Our client is seeking an EPIC Physician Billing Analyst to join their team. An Epic Physician Billing Analyst (also known as an Epic Professional Billing Analyst) is responsible for the configuration, maintenance, and optimization of the Epic Professional Billing module within a healthcare organization. This role is vital for ensuring accurate patient billing, claims processing, and reimbursement for services provided by individual healthcare providers, such as doctors or therapists. & Key Responsibilities: • System Configuration and Maintenance:, • Configure and customize the Epic Professional Billing application to meet the specific business needs and workflows of the organization., • Maintain the Resolute Professional Billing module to manage charges, benefit engines, and workflows with external collection agencies., • Perform ongoing maintenance and updates to Epic applications., • Build and test system changes, presenting them to end-users and migrating them to production., • Workflow Analysis and Optimization:, • Analyze existing financial workflows and identify opportunities for improvement and optimization., • Design and implement leading practice workflows to enhance efficiency and effectiveness., • Collaborate with various stakeholders, including IT, finance, and end-users, to ensure the Epic system aligns with business operations., • Support and Troubleshooting:, • Act as the primary support contact for Epic Professional Billing application end-users., • Provide support to end-users on the Epic EMR system, including integrating revenue cycle processes such as maintaining claim scrubbers and payment processors., • Troubleshoot system errors and resolve issues related to billing, claims, and reimbursement., • Provide on-call support on a rotating basis., • Training and Education:, • Participate in training and educate end-users on the Epic Professional Billing application and related workflows., • Develop and document internal procedures for using Epic and other applications., • Compliance and Updates:, • Stay current with Epic technologies, obtain and maintain necessary Epic certifications., • Ensure compliance with industry standards and regulations, such as transitioning between different claim formats (e.g., X12 4010 to 5010) and coding systems (e.g., ICD-9 to ICD-10). Essential skills and qualifications: • Education and Certification:, • Bachelor’s Degree, preferably in Computer Science, Information Technology, Computer Engineering, or a related field., • Certified in Epic Professional Billing., • Technical Skills:, • Expertise in Epic's Professional Billing module, including charge router, workqueue configuration, collection agency workflows, statement processing, benefit engine, and estimates., • Experience with system configuration and troubleshooting tools., • Proficiency with Microsoft Office Suite (Word, Project, Excel, Visio, and PowerPoint)., • Healthcare Industry Knowledge:, • Strong understanding of healthcare revenue cycle processes, medical billing codes, and insurance procedures., • Familiarity with the differences between professional billing and hospital billing., • Knowledge of medical coding systems like CPT and ICD-10., • Soft Skills:, • Strong interpersonal relationship skills and effective communication skills (both oral and written)., • Analytical thinking and problem-solving abilities., • Attention to detail and accuracy., • Self-motivated and a team player.