Epic Consultant - Patient Refunds (Revenue Cycle)

Job Description

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

• 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.