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Our client is seeking a Senior Professional Billing and Claims Consultant for a 5-month remote contract. This full-time role is responsible for providing expert support for Epic Professional Billing and Claims operations, including configuring, troubleshooting, and optimizing Charge Router workflows, payment and remittance processes, and resolving complex billing and revenue cycle issues. The consultant will play a key role in new Epic site implementations, go-live support, and post-implementation optimization, collaborating with operational leaders, IT teams, and vendors. The position also demands subject matter expertise in Rural Health Clinic and Critical Access Hospital billing, ensuring compliance with regulatory requirements and supporting reimbursement optimization. Additional responsibilities include participating in Epic upgrades, recommending system enhancements, mentoring junior staff, and contributing to documentation and training. Candidates must have at least 5 years of Epic Professional Billing and Claims experience, relevant certifications, and strong leadership, communication, and problem-solving skills.
Job Responsibility
Provide senior-level support for Epic Professional Billing and Claims operations, including configuration, troubleshooting, and optimization of Charge Router and related billing workflows
Support payments and remittance workflows, including payment posting, reconciliation, denial analysis, and remittance troubleshooting
Investigate and resolve complex billing, claims, and revenue cycle tickets within established SLA timelines
Partner with operational and technical teams, as well as third-party vendors, to improve billing efficiency, claims accuracy, and reimbursement outcomes
Support new Epic site implementations, including pre-implementation planning, workflow validation, build review, operational readiness, integrated testing, defect resolution, and end-user support during go-live stabilization
Assist with cutover planning and post-go-live optimization activities
Provide subject matter expertise in Rural Health Clinic (RHC) billing, Critical Access Hospital (CAH) Method II billing, and Provider-Based Billing workflows
Ensure workflows and configurations align with regulatory and reimbursement requirements, supporting operational teams in identifying compliance risks and reimbursement optimization opportunities
Participate in Epic upgrade activities, including review and analysis of Nova Notes, system testing and validation, workflow impact assessments, and coordination of upgrade-related changes
Recommend system enhancements and operational improvements based on Epic best practices and organizational needs
Mentor and assist junior analysts and consulting staff, providing knowledge transfer, workflow guidance, and escalation support
Serve as a senior escalation point for complex Professional Billing and Claims issues
Contribute to documentation standards, training materials, and operational best practices
Requirements
5+ years of Epic Professional Billing and/or Claims experience in a healthcare environment
Strong understanding of Charge Router, payments & remittance workflows, claims processing, denial management, and revenue cycle operations
Experience supporting new Epic site implementations and go-live activities, including workflow validation, build review, and operational readiness
Knowledge of Rural Health billing, Critical Access Hospital Method II billing, and Provider-Based billing
Experience supporting Epic upgrades, including review and analysis of Nova Notes, system testing, and workflow impact assessments
Proven ability to troubleshoot and resolve complex ticketing and workflow issues
Experience mentoring or leading junior staff members, providing knowledge transfer and workflow guidance
Strong communication, organizational, and stakeholder management skills
Epic Professional Billing and Claims Certifications
What we offer
Competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage
401k plan with company match fully vested after eligibility
Paid time off, sick time, and paid company holidays
Employee Assistance Program (EAP) providing virtual counseling, financial services, legal services, life coaching