Epic Consultant - Patient Refunds (Revenue Cycle)
Location: Remote
Experience: (8 15) years
Employment Type: Contract
Rate: Market Standard C2C
About the Role
We are seeking an Epic Consultant with a strong Revenue Cycle Management (RCM) and Accounts Payable (A/P) background to support our Epic-based patient refund solution. The ideal candidate understands the business logic of patient credit balances and refunds at a deep level, can validate EOBs, and can identify why an Epic patient refund fails. A technical profile is welcome, but deep business understanding is essential. This is a non-clinical role.
Key Responsibilities
Support and analyze the end-to-end patient refund workflow in Epic, from credit balance identification
through refund request, approval, and payment issuance.
Validate EOBs (Explanation of Benefits) and remittance data to confirm that credit balances are valid and
refunds are owed to the patient rather than the payer.
Identify, research, and determine root cause when an Epic patient refund fails or is rejected.
Work with Epic Resolute (HB/PB/SBO) configuration and workqueues to review patient credit balances
and refund eligibility.
Use Epic KIT objects and related Epic modules to trace transactions, accounts, and refund records.
Map US payment data models to Epic KIT objects to support refund processing and integration.
Work with A/P processes for refund disbursement, including check and electronic payment handling and
reconciliation.
Document refund scenarios, exceptions, and resolution steps.
Collaborate with business, revenue cycle, finance, A/P, and IT teams to translate business rules into
system behavior and vice versa.
Support testing, validation, and issue resolution during the engagement.
Required Skills and Experience
Proven experience in Revenue Cycle Management (RCM) and Accounts Payable (A/P) in the US
healthcare market.
Working knowledge of Epic Resolute (HB and/or PB) and related revenue cycle concepts.
Familiarity with Epic KIT objects and other relevant Epic modules and integration concepts.
Strong understanding of the Patient Refund workflow in Epic.
Ability to validate EOBs and reconcile them against account and credit balances.
Ability to identify the cause of failed Epic patient refunds and recommend or drive resolution.
Deep understanding of the business logic behind refunds, along with the technical flow (a technical
profile is acceptable).
Strong analytical, documentation, and communication skills.
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