Epic Resolute Professional Billing (PB) & Claims Analyst

Employment Type: Full Time

We are seeking an experienced Epic Resolute Professional Billing (PB) & Claims Analyst to join our healthcare IT team. The ideal candidate will have hands-on experience in implementing, configuring, supporting, and optimizing the Epic Resolute Professional Billing (PB) module, with expertise in claims management and physician revenue cycle workflows. The candidate will collaborate with billing, coding, revenue cycle, and operational teams to enhance billing accuracy, streamline claims processing, and improve reimbursement outcomes.

Key Responsibilities

• Configure, maintain, and support the Epic Resolute Professional Billing (PB) application.
  
• Gather, analyse, and document business and operational requirements from professional billing and revenue cycle stakeholders.
  
• Design, build, test, validate, and deploy Epic Resolute PB enhancements and system changes.
  
• Configure and support physician billing workflows, charge capture, claims generation, payment posting, denials management, and reimbursement processes.
  
• Support electronic claims submission, claim edits, remittance processing, and claims troubleshooting.
  
• Troubleshoot production issues, perform root cause analysis, and implement system improvements.
  
• Participate in Epic implementations, upgrades, optimisation initiatives, and enhancement projects.
  
• Execute unit testing, integrated testing, and User Acceptance Testing (UAT).
  
• Develop and maintain build documentation, workflow diagrams, technical specifications, and support documentation.
  
• Collaborate with other Epic application analysts to ensure seamless integration with Hospital Billing (HB), Patient Access, Cadence, Prelude, and other Epic modules.
  
• Ensure all configurations comply with Epic best practices, payer requirements, and healthcare regulatory standards.
  

Requirements

• 3+ years of hands-on experience with Epic Resolute Professional Billing (PB) and Claims.
  
• Epic Resolute Professional Billing (PB) Certification is mandatory.
  
• Experience in Epic build, configuration, implementation, testing, and production support.
  
• Strong understanding of physician billing, professional claims processing, coding, charge capture, reimbursement, and revenue cycle workflows.
  
• Experience working with electronic claims transactions and payer processes.
  
• Excellent analytical, troubleshooting, and problem-solving skills.
  
• Strong verbal and written communication skills.
  
• Ability to work independently and collaboratively in a fast-paced healthcare environment.
  

Mandatory Requirements

• Epic Resolute Professional Billing (PB) Certification (Mandatory)
  
• Minimum 3 years of relevant Epic Resolute PB experience
  
• Experience supporting Professional Billing (PB) and Claims workflows.
  
• Excellent communication skills.
  

Preferred Skills

• Experience in U.S. healthcare professional billing and revenue cycle operations.
  
• Knowledge of physician billing, CPT/ICD coding concepts, claims adjudication, payment posting, denials management, and reimbursement processes.
  
• Experience integrating Epic Resolute PB with Hospital Billing (HB), Patient Access, Cadence, Prelude, and other Epic applications.
  
• Understanding of Epic implementation methodology and healthcare interoperability.
  
• Strong documentation, stakeholder management, and communication skills.