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The Epic Professional Billing Claims Analyst is responsible for resolving outstanding tickets related to professional billing and claims workflows while supporting end-to-end claims processes. This role involves collaboration with various teams to troubleshoot issues and act as a subject matter expert in professional billing claims workflows.
Candidates must have an active certification in PB claims and a strong working knowledge of professional billing claims workflows. A minimum of 2 years of experience in a healthcare billing or revenue cycle analyst role is required.
Key Responsibilities Ticket Backlog Resolution Review, analyze, and resolve outstanding tickets related to professional billing and claims workflows. Prioritize issues based on claim impact, financial risk, and compliance requirements. Provide clear, detailed documentation of resolution steps and communicate effectively with requesters. Claims Workflow Support Support end-to-end professional billing claims processes, including charge capture, claim edits, scrubbing, submission, denials, and remittance. Identify patterns in recurring issues and recommend long-term process or system fixes. Partner with IT to validate system build/configuration changes and test claim workflows. Collaboration & Escalation Collaborate with billing teams, patient financial services, compliance, and IT teams to troubleshoot and resolve issues. Act as a subject matter expert (SME) for professional billing claims workflows. Escalate systemic, high-priority, or compliance-related issues to leadership and external vendors as appropriate. Required PB claims Active Cert Strong working knowledge of professional billing claims workflows and revenue cycle operations. 2+ years of experience in a healthcare billing, claims, or revenue cycle analyst role. Proven experience in post-live support or system stabilization, with a focus on claims processing. Demonstrated ability to resolve high-volume ticket backlogs with accuracy and efficiency. Strong analytical, troubleshooting, and problem-solving skills.
This job posting was last updated on 9/26/2025