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Epic Resolute Professional Billing (PB) Claims Analyst

Job Description

This fully remote contract role focuses on supporting and optimizing Epic Resolute Professional Billing (PB) claims operations across a multi-site health system. You will manage and improve claims administration, electronic remittance processing, claim edits, reimbursement workflows, and key revenue cycle initiatives. Partnering closely with Revenue Cycle Operations, Patient Financial Services, HIM, Finance, and Clinical Operations, you will help ensure accurate claims processing, efficient reimbursement, and continuous enhancement of Epic Resolute PB functionality.

Responsibilities

+ Support and optimize Epic Resolute Professional Billing (PB) claims operations, including end-to-end claims lifecycle management.

+ Configure, maintain, and enhance Epic Resolute PB Claims and PB Administration to support accurate and timely claims processing.

+ Manage and refine professional billing claim edits to reduce errors, prevent denials, and improve first-pass resolution rates.

+ Build and maintain remittance workqueues and electronic remittance processing workflows to ensure efficient reimbursement and posting.

+ Monitor and support hospital billing claims and electronic remittance processes as needed to ensure alignment across billing functions.

+ Oversee and maintain payer status queries, RMO mapping, RMC updates, and CARC/RARC implementation to align with payer requirements.

+ Perform claims reconciliation activities to ensure data accuracy, identify discrepancies, and support financial integrity.

+ Conduct integrated testing for new build, changes, and upgrades in Epic Resolute PB, ensuring stability and accuracy of claims-related workflows.

+ Support Community Connect and multi-site health system implementations, ensuring consistent and scalable billing and claims processes.

+ Analyze operational workflows in collaboration with Revenue Cycle Operations, Patient Financial Services, HIM, Finance, and Clinical Operations to identify opportunities for revenue cycle optimization.

+ Provide production support for Epic Resolute PB Claims, including troubleshooting, issue resolution, and root cause analysis.

+ Manage build migration and validation activities to ensure changes move accurately and safely through environments into production.

+ Contribute to and support mergers, acquisitions, or large-scale Epic optimization efforts by aligning claims and billing processes.

+ Maintain up-to-date knowledge of payer requirements and regulatory changes and translate them into Epic build and workflow updates.

+ Collaborate with leadership and cross-functional stakeholders to define claims strategy, influence business outcomes, and drive continuous improvement.

Essential Skills

+ Hands-on experience with Epic Resolute Professional Billing (PB) Claims, including claims lifecycle management and administration.

+ Demonstrated expertise in Epic Resolute PB Administration, including configuration, maintenance, and optimization of claims workflows.

+ Strong understanding of professional billing claims, hospital billing claims, and electronic remittance processing.

+ Experience building and maintaining professional billing claim edits to support denial prevention and clean claim submission.

+ Experience with remittance workqueue build and electronic remittance processing in Epic.

+ Proficiency in claims reconciliation, including identifying and resolving discrepancies across systems and workflows.

+ Experience with payer requirements management, including CARC/RARC maintenance and implementation.

+ Ability to perform integrated testing for Epic changes related to claims, billing, and revenue cycle workflows.

+ Experience providing production support for Epic Resolute PB Claims, including troubleshooting and issue resolution.

+ Demonstrated ability to conduct operational workflow analysis and drive revenue cycle optimization initiatives.

+ Experience with build migration and validation processes in Epic environments.

+ Ability to collaborate effectively with Revenue Cycle Operations, Patient Financial Services, HIM, Finance, and Clinical Operations teams.

+ Strong analytical, problem-solving, and communication skills, with a focus on accuracy and process improvement.

Additional Skills and Qualifications

+ Epic Resolute Professional Billing Administration Certification (preferred).

+ Epic Resolute Hospital Billing Claims/Electronic Remittance Certification (preferred but not required).

+ Experience supporting mergers, acquisitions, or large-scale Epic optimization efforts.

+ Experience supporting multi-site health systems and Community Connect environments.

+ Familiarity with RMO mapping, RMC updates, and payer status query configuration.

+ Experience with revenue cycle optimization initiatives across complex healthcare organizations.

+ Comfort working in a fully remote environment and collaborating with distributed teams.

+ Contract assignment with an expected duration of approximately 6 months.

Work Environment

This is a 100% remote role based in the United States. Work may be performed from Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Ohio, Oklahoma, Texas, Utah, and Virginia; remote work from other states is not permitted at this time. You will work in a virtual environment using Epic Resolute PB and related Epic modules, along with standard collaboration and communication tools to interact with Revenue Cycle, HIM, Finance, and Clinical Operations teams. The assignment is structured as a contract role with an expected duration of approximately 6 months, offering a professional, outcomes-focused environment where you collaborate with cross-functional stakeholders to support and enhance revenue cycle operations.

Job Type & Location

This is a Contract position based out of Kansas City, MO.

Pay and Benefits

The pay range for this position is $80.00 - $90.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract position based out of Kansas City, MO.

Application Deadline

This position is anticipated to close on Oct 27, 2026.

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