Epic Professional Billing (PB) Analyst

Job Summary:

The Epic Professional Billing (PB) Analyst with Claims experience is responsible for supporting, configuring, and optimizing Epic PB workflows with a strong focus on claims processing, billing accuracy, and revenue cycle performance. The analyst will work closely with revenue cycle teams, providers, and payers to ensure compliant and efficient claim submission and reimbursement.

Key Responsibilities:

• Configure, build, and maintain Epic Professional Billing (PB) application.

• Support end-to-end claims lifecycle including claim creation, edits, submission, rejections, denials, and follow-ups.

• Analyze and resolve claim errors, rejections, and payer denials.

• Configure claim edits, billing rules, charge routing, and workqueues.

• Collaborate with coding, compliance, and revenue cycle teams to ensure accurate billing.

• Perform testing (unit, integrated, and UAT) for PB and claims-related changes.

• Support clearinghouse interfaces and payer-specific requirements.

• Assist with system upgrades, enhancements, and regulatory changes.

• Develop and maintain documentation, workflows, and training materials.

• Provide production support and issue resolution for PB claims and billing issues.

Required Skills & Qualifications:

• Epic Professional Billing (PB) certification (required).

• Strong hands-on experience with Epic PB claims workflows.

• Experience working with claim edits, workqueues, EDI 837P, and remittance (835).

• Knowledge of CPT, ICD-10, HCPCS, and modifiers.

• Understanding of payer rules, CMS guidelines, and reimbursement methodologies.

• Experience with charge capture, fee schedules, and provider enrollment.

• Strong analytical and problem-solving skills.

• Excellent communication and stakeholder collaboration skills.

Preferred Qualifications:

• Experience with Epic Resolute PB.