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EPIC Solution Design Consultant || Visa independent consultant
EPIC Solution Design Consultant || Visa independent consultantShrive Technologies LLC • Pleasanton, CA, United States
EPIC Solution Design Consultant || Visa independent consultant

EPIC Solution Design Consultant || Visa independent consultant

Shrive Technologies LLC • Pleasanton, CA, United States
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Required Skills & Qualifications

  • Experience : 5+ years of experience working with EPIC systems in an analyst or architect capacity within a healthcare setting
  • Epic Certification : Active Epic certification(s) in relevant Revenue Cycle modules (e.g., Resolute PB, Resolute HB, Claims, Tapestry) is required.
  • Technical Skills : In-depth knowledge of healthcare revenue cycle operations, electronic claims processing standards (e.g., EDI, specific claim forms), system integration standards such as HL7 & FHIR, and system configuration. Strong analytical and problem-solving skills are essential.

System Architecture & Design : Lead the design and architecture of the Epic Claims modules, including Resolute Professional Billing (PB) and Hospital Billing (HB), focusing on claims, billing, and accounts receivable workflows.

  • Implementation & Configuration : Plan, configure, test, and implement Epic software updates and new functionality, translating complex business requirements into practical system solutions.
  • Workflow Analysis & Optimization : Collaborate with clinical and administrative leadership to perform workflow analysis, identify areas for improvement, and optimize system use to enhance efficiency and ensure regulatory compliance.
  • Integration Management : Design and manage integrations between Epic and third-party systems related to claims submission, payment processing, and other financial operations.
  • Analyze business requirements and translate them into scalable, secure, and compliant solution designs for healthcare and insurance domains.
  • Configure and optimize EPIC system workflows to support health insurance processes, including eligibility, claims management, billing, and prior authorization.
  • Ensure interoperability between EPIC modules and external payer systems, utilizing standards such as HL7, FHIR, and EDI for robust data exchange.
  • Collaborate with business analysts, project managers, and technical teams to validate requirements and design effective solutions.
  • Facilitate workshops with clinical, administrative, and payer stakeholders to gather insights and continuously improve workflows.
  • Configure EPIC modules (e.g., Tapestry, Resolute, Benefits Engine) for insurance-related functionalities and support integration strategies for claims processing, eligibility verification, and premium billing.
  • Provide expert guidance on HIPAA compliance and data security best practices throughout solution design and implementation.
  • Develop comprehensive solution design documentation, including data flow diagrams and integration specifications, maintaining compliance with organizational architecture standards and regulatory requirements.
  • Act as a subject matter expert for troubleshooting and optimization, leading detailed design efforts and workflow planning within project squads.
  • Translate complex business requirements into clear, actionable technical specifications and contribute to user story creation, ensuring acceptance criteria are well-defined.
  • Develop and maintain design documentation, updating regularly throughout the project lifecycle to ensure accuracy and completeness.
  • Collaborate with technical SMEs to provide necessary details for successful completion of development stories.
  • Lead design and technical discussions across squads and teams to ensure alignment, integration, and successful project outcomes.
  • Partner with Product Managers and Scrum Masters for sprint and Program Increment (PI) planning, and work closely with other squads to define feature strategies for projects and initiatives.
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    Design Consultant • Pleasanton, CA, United States

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