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Talented Medical Solutions seeks an experienced medical billing professional to manage Epic Resolute HB work queues in Roseville, CA. You will review claims, correct errors, process denials and credits, and support timely reimbursement.
The role requires 2+ years in medical billing and hands-on Epic Resolute HB experience, with proficiency in UB-04, CMS-1500, CPT/HCPCS, ICD-10, and payer rules. You will collaborate across billing, coding, registration, clinical, and IT teams.
Job Summary:
Manages daily Epic Resolute Hospital Billing (HB) work queues, including claim edits, charge review, follow-up, denials, and credits. Resolves billing errors and supports accurate, timely reimbursement.
Monitor and resolve assigned Epic billing work queues.
Review claim edits and correct patient, guarantor, coverage, and charge-level errors.
Prioritize accounts based on dollar value, aging, timely filing, and departmental priorities.
Identify recurring billing errors and cascade systemic issues.
Collaborate with billing, coding, registration, clinical, and IT/Epic teams.
Document account activity accurately in Epic.
Support work queue, routing, workflow, and process improvements.
Assist with Epic upgrades, testing, and billing edits.
Maintain knowledge of payer requirements and billing regulations.
Follow HIPAA, privacy, safety, and organizational policies.
Requirements:
High School Diploma/GED or equivalent – Required.
Associate’s/Technical Degree or equivalent education/experience – Preferred.
2+ years of medical billing, claims processing, or revenue cycle experience – Required.
1+ year of hands‑on Epic Resolute billing work queue experience (HB, PB, or both) – Required.
Working knowledge of UB-04, CMS-1500, CPT, HCPCS, ICD-10, and revenue codes – Required.
Experience with commercial, Medicare, Medicaid, and managed care billing – Required.
Clearinghouse platforms such as SSI and payer portals such as Availity, Waystar, or Experian – Preferred.
Experience with work queue build, routing rules, or workflow redesign – Preferred.
Epic Resolute HB certification, proficiency, or credentialed training – Preferred.
CRCR, CPB, or comparable revenue cycle certification – Preferred.