Revenue Cycle Specialist

Healthcare IT Leaders; California; On-site; USD 55,000 - 96,000; Full time

Job summary

Healthcare IT Leaders, LLC is seeking an experienced Revenue Cycle Specialist, focusing on Epic Resolute Professional Billing workflows and complex claims management in the Los Angeles area.

The role involves insurance follow-up, denial resolution, and payment posting across Medicare, Medi-Cal, and other payers. A minimum of 2 years in healthcare revenue cycle is required, with strong CPT/HCPCS/ICD-10-CM knowledge.

Qualifications

• Hands-on Epic Resolute Professional Billing experience required.
• Minimum 2 years in healthcare revenue cycle or related roles.
• Experience with Medicare, Medi-Cal, and other payers.
• Knowledge of CPT, HCPCS, ICD-10-CM, and denial codes.
• Strong ability to review EOBs, ERAs, and payer communications.

Responsibilities

• Support Epic Resolute Professional Billing workflows (claims processing, workqueues, remittance, guarantor accounts, patient billing).
• Manage insurance follow-up, AR, denials, appeals, and payment discrepancies.
• Review and interpret EOBs, ERAs, payer correspondence, denial notices, and rejections.
• Research payer requirements, timely filing guidelines, and appeal procedures.
• Collaborate with Medicare, Medi-Cal, California Medicaid managed care plans, commercial insurers, workers' compensation, and third-party administrators.
• Apply CPT, HCPCS, ICD-10-CM, modifiers, medical necessity, claim forms, and denial codes to support accurate billing and reimbursement.
• Identify recurring billing issues and collaborate with revenue cycle teams to improve collections, reduce denials, and optimize workflows.
• Support revenue cycle reporting, account research, and resolution of outstanding receivables.

Skills

Epic Resolute Professional Billing

Revenue cycle management

Claims processing

Denial management

Tools

Epic Workqueues

Remittance processing

Payer portals

Job description

Revenue Cycle Specialist

Our Los Angeles based client is seeking an experienced Epic Resolute Professional Billing Analyst to support healthcare revenue cycle operations, with a focus on claims management, insurance follow-up, denial resolution, payment posting, and patient billing. The ideal candidate will have hands‑on Epic Resolute Professional Billing experience, a strong understanding of healthcare reimbursement processes, and the ability to investigate and resolve complex billing and payer‑related issues. The duration is 6 months contract.

Responsibilities

• Support Epic Resolute Professional Billing workflows, including claims processing, workqueues, remittance, guarantor accounts, and patient billing.


• Manage insurance follow‑up, accounts receivable, claim rejections, denials, appeals, and payment discrepancies.


• Review and interpret EOBs, ERAs, payer correspondence, denial notices, and clearinghouse rejections to determine appropriate resolution.


• Research payer requirements, reimbursement policies, timely filing guidelines, and appeal procedures.


• Work with Medicare, Medi‑Cal, California Medicaid managed care plans, commercial insurers, workers' compensation, and third‑party administrators.


• Apply knowledge of CPT, HCPCS, ICD‑10‑CM, modifiers, medical necessity, claim forms, and denial codes to support accurate billing and reimbursement.


• Identify recurring billing issues and collaborate with revenue cycle teams to improve collections, reduce denials, and optimize workflows.


• Support revenue cycle reporting, account research, and resolution of outstanding receivables.

Qualifications & Requirements

• Minimum of 2 years of healthcare revenue cycle, medical billing, accounts receivable, insurance follow‑up, denial management, payment posting, patient billing, or business office experience.


• Hands‑on Epic Resolute Professional Billing experience is required.


• Experience with Epic workqueues, claims, remittance, guarantor accounts, patient billing, and reporting workflows preferred.


• Experience working with Medicare, Medi‑Cal, California Medicaid managed care plans, commercial insurance, workers' compensation, and third‑party administrators.


• Strong understanding of EOBs, ERAs, payer portals, clearinghouse rejections, denial notices, appeals, timely filing requirements, and reimbursement policies.


• Working knowledge of CPT, HCPCS, ICD‑10‑CM, modifiers, medical necessity, payer reimbursement methodologies, claim forms, and denial codes.

Preferred Certifications

• Certified Professional Biller (CPB)


• Certified Coding Associate (CCA)


• Certified Professional Coder (CPC)


• Certified Revenue Cycle Representative (CRCR)
  
• Or equivalent healthcare billing or revenue cycle certification.