Epic Professional Billing Claims Analyst
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Job Description
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.
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Automate your job search with Sonara.
Submit 10x as many applications with less effort than one manual application.