We are seeking an experienced Epic PB (Professional Billing) Analyst with strong Epic PB Claims expertise to support the implementation, optimization, and maintenance of Epic Resolute Professional Billing. The ideal candidate will have hands-on experience with claims processing, reimbursement workflows, revenue cycle operations, and Epic system configuration.
Required Skills & Qualifications
- Active Epic Resolute Professional Billing (PB) Certification (PB Claims certification preferred)
- 4+ years of hands-on experience supporting Epic PB and Claims
- Strong knowledge of Professional Billing, claim generation, claim edits, denials, remittance, and reimbursement workflows
- Experience configuring Epic PB workqueues, claim edits, charge router, billing rules, and payment posting
- Knowledge of EDI transactions (837/835), payer requirements, and revenue cycle processes
- Experience with workflow analysis, system build, testing (unit, integrated, and UAT), and go-live support
- Ability to troubleshoot billing and claims issues and collaborate with Revenue Cycle, IT, and operational teams
- Experience with system upgrades, enhancements, and production support
- Strong communication, documentation, and problem-solving skills
Preferred Qualifications
- Epic PB Claims and Electronic Remittance certification
- Experience with charge capture, claim scrubbing, denial management, and payment reconciliation
- Experience in Epic implementations, optimizations, or support projects
- Knowledge of SQL, reporting tools, or Revenue Cycle reporting is a plus
Responsibilities
- Configure and maintain Epic Resolute PB and Claims functionality.
- Support end-to-end professional billing and claims workflows.
- Analyze business requirements and translate them into Epic system configuration.
- Resolve production issues related to claims, reimbursement, and billing operations.
- Perform system testing, validation, and documentation for enhancements and upgrades.
- Collaborate with Revenue Cycle stakeholders to improve billing efficiency and claims performance.
- Provide ongoing production support and participate in optimization initiatives.
Empowering the Future of Healthcare
The healthcare Industry is on the brink of a paradigm shift where patients are increasingly being viewed as empowered consumers, utilizing digital technologies to better understand and manage their own health. As a result, there is a growing demand for a range of patient-centric services, including personalized care that is tailored to each individual's unique needs, health equity that ensures access to care for all, price transparency to make healthcare more affordable, streamlined prior authorizations for medications, the availability of therapeutic alternatives, health literacy to promote informed decision-making, reduced costs, and many other initiatives designed to improve the patient experience.
ClinDCast is at the forefront of shaping the future of healthcare by partnering with globally recognized healthcare organizations and offering them innovative solutions and expert guidance. Our suite of services is designed to cater to a broad range of needs of healthcare organizations, including healthcare IT innovation, electronic health record (EHR) implementation & optimizations, data conversion, regulatory and quality reporting, enterprise data analytics, FHIR interoperability strategy, payer-to-payer data exchange, and application programming interface (API) strategy.