Epic Professional Billing Claims Analyst

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.