Epic PB Analyst

TEKsystems; Kansas City (MO); Remote; USD 65,000 - 95,000; Full time

Job summary

TEKsystems seeks an Epic Resolute PB Claims Analyst for a fully remote contract role focused on supporting and optimizing PB claims operations across a multi-site health system. You will manage and improve claims administration, remittance processing, and related reconciliation workflows, collaborating with Revenue Cycle Operations, Patient Financial Services, HIM, and Finance.

Key responsibilities include configuring PB Claims and PB Administration, reducing denials, ensuring accurate

Qualifications

• Hands-on experience with Epic Resolute PB Claims and PB administration.
• Strong understanding of professional and hospital billing claims and EDI remittance processing.

Responsibilities

• Support and optimize Epic Resolute PB claims operations across multiple sites.
• Configure, maintain, and enhance Epic Resolute PB Claims and PB Administration workflows.
• Manage and refine professional billing claim edits to reduce denials and improve first-pass resolution.
• Build and maintain remittance workqueues and electronic remittance processing workflows.

Skills

Epic PB Claims

Claims lifecycle

Remittance processing

CARC/RARC

Integrated testing

Production support

Payer requirements

Cross-functional

Analytical skills

Job description

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