Epic RTE Analyst
a { text-decoration: none; color: #464feb;}tr th, tr td { border: 1px solid #e6e6e6;}tr th { background-color: #f5f5f5;} Position Summary We are seeking an Epic RTE (Real-Time Eligibility) Certified Analyst/Consultant to support, monitor, maintain, and enhance Epic RTE functionality across the organization. This individual will serve as a key resource for optimizing eligibility workflows, resolving operational issues, implementing new functionality, and supporting strategic initiatives related to insurance verification, benefits, coverage discovery, filing order automation, and denial prevention. The consultant will initially focus on prioritizing and resolving existing tickets and enhancement requests, improving plan mapping processes, and ensuring the stability and effectiveness of RTE operations. The role will also provide mentoring and knowledge transfer to a junior RTE analyst, helping expand internal expertise and long-term support capabilities.
Key Responsibilities
Operational Support & Maintenance Monitor and support Epic RTE production environments and related interfaces. Prioritize and resolve ServiceNow tickets, operational requests, incidents, and enhancement requests. Manage and troubleshoot payer availability issues, payer outages, and response time concerns. Investigate and resolve high-priority unplanned eligibility issues. Open and manage Experian support cases when appropriate. RTE Configuration & Build Maintain and enhance: Plan Mapping configurations Query Chaining logic and payer routing tables Coverage Auto-Creation rules RTE Alerts and Highlights Facility and Visit Filing Order configurations
Benefits
Engine configurations Visit Type Benefit Grouper (VTBG) settings Design, test, and implement new RTE functionality to support operational and regulatory requirements. Eligibility & Coverage Discovery Monitor and support: Experian Coverage Discovery transactions Eligibility response processing Coverage auto-creation workflows Medicare and Medicaid query processes Quality control tables and related work queues Analyze payer responses and improve automation to increase clean registration and coverage accuracy. Reporting & Analytics Develop, finalize, and maintain RTE operational and denial prevention reporting. Configure batch reporting processes and automated file delivery. Support reporting initiatives including: MSPQ reporting HAR reporting Plan Map by Payer reporting Professional Billing visit reporting Copay collection reporting Denial prevention reporting and root-cause analysis Partner with operations teams to identify reporting opportunities that improve revenue cycle performance. Revenue Cycle Optimization Support benefits filing processes and benefits engine enhancements. Analyze copay collection opportunities and payer-specific configurations. Support denial prevention initiatives through data analysis and workflow improvements. Implement enhancements to improve coverage accuracy, filing order logic, and reimbursement outcomes. Stakeholder Collaboration Meet regularly with Revenue Cycle, Patient Access, Operations, HB/PB, and Registration leadership. Evaluate new business requests and provide guidance regarding Epic RTE capabilities and best practices. Recommend scalable solutions aligned with Epic standards and organizational goals. Partner with operational teams on Medicaid, Hospice, Home Health, Financial Assistance, and other strategic initiatives. Mentorship & Knowledge Transfer Provide hands-on mentoring and training to junior RTE team members. Assist in growing internal expertise related to: RTE build Eligibility processing Plan Mapping Filing Order logic
Benefits
Engine functionality Reporting and troubleshooting Create and maintain documentation, troubleshooting guides, and operational procedures.
Required Qualifications
Epic RTE (Real-Time Eligibility) Certification required. 5+ years of Epic Revenue Cycle experience with significant RTE build and support responsibilities. Strong understanding of: Eligibility Verification Coverage Discovery Plan Mapping Filing Order Logic
Benefits
Engine Patient Access workflows Revenue Cycle operations Experience supporting production environments and troubleshooting payer connectivity issues. Experience with reporting, data analysis, and operational performance improvement. Experience working with cross-functional operational and technical teams. Strong communication, problem-solving, and consulting skills.
Preferred Qualifications
Additional Epic certifications in HB, PB, Prelude, Cadence, or Referrals. Experience with Experian Coverage Discovery. Experience with Medicare and Medicaid eligibility processing. Experience with denial prevention initiatives and revenue cycle optimization. Previous mentoring or training experience. Healthcare system or multi-hospital enterprise experience. Key Areas of Responsibility Payer Availability Monitoring Experian Coverage Discovery Query Chaining Maintenance Plan Mapping Configuration Coverage Auto-Creation RTE Alerts & Highlights Filing Order Configuration MSPQ Support Denial Prevention Reporting
Benefits
Engine Support Visit Type Benefit Grouper Management Copay Automation & Analysis Medicaid Program Support Hospice & Home Health Eligibility Support Work Queue Design and Optimization Knowledge Transfer & Team Development