Epic Professional Billing Claims Analyst

Title: Epic Professional Billing (PB) Claims Analyst

Location: California, United States

Work Type: Remote, Full Time

Job ID:14232

Position: Contract

Job Description:

Duties:
The Epic Program Director will oversee the build, configuration, testing, and support of Epic Professional Billing (PB) Claims functionality, with a focus on Behavioral Health and Ambulatory service lines

Key responsibilities include:

• System Configuration & Build: Configure and maintain Epic PB Claims functionality, including claim edit rules, charge review workqueues, and payer-specific logic. Build and optimize workflows to meet unique Behavioral Health and Ambulatory billing requirements across multiple states.

• Claims Management & Troubleshooting: Monitor claim generation for accuracy and compliance, investigate claim errors, rejections, and denials, and implement corrective actions or system enhancements.

• Testing & Optimization: Develop test plans, conduct system testing for new builds, upgrades, and enhancements, and validate end-to-end claims processing, including 837P file generation and 835 remittance mapping.

• Stakeholder Collaboration: Liaise with revenue cycle leadership, billing managers, coding, and compliance teams to translate business requirements into Epic configurations. Provide training, documentation, and support to end users as needed.

Skills:

• Strong problem-solving and analytical skills

• Ability to manage multiple tasks and meet deadlines

• Excellent written and verbal communication skills

• Attention to detail and commitment to data accuracy

• Ability to work collaboratively in cross-functional teams

Experience:

• Minimum 5 years of experience supporting Epic Professional Billing Claims in a healthcare environment

• Epic PB Certification

• In-depth knowledge of professional billing for Behavioral Health and Ambulatory services

• Understanding of CPT/HCPCS coding, payer rules, and CMS/MCO guidelines

Preferred Experience:

• Experience with Epic modules such as Charge Router, Prelude/ADT, and Professional Billing Admin

• Familiarity with behavioral health billing regulations, including state-specific Medicaid guidelines and bundled service billing

• Experience in multi-site healthcare systems, FQHCs, or behavioral health organizations

• Knowledge of claim file formats (837P, 835) and clearinghouse integrations

• Experience with Epic reporting tools (e.g., Reporting Workbench, Radar)

Education:

• Bachelor’s degree in Healthcare Administration, Information Systems, Business, or related field, or equivalent work experience

Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.

CTG does not accept unsolicited resumes from headhunters, recruitment agencies, or fee-based recruitment services for this role.

The expected base salary for this position ranges from $115,000 to $130,000. Salary offers are based on a wide range of factors including relevant skills, training, experience, education, market factors, and where applicable, licensure or certifications obtained. In addition to salary, a competitive benefit package is also offered.
About CTG

CTG, a Cegeka company, is at the forefront of digital transformation, providing IT and business solutions that accelerate project momentum and deliver desired value. Over nearly 60 years, we have earned a reputation as a faster and more reliable, results-driven partner. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. CTG leverages the expertise of over 9,000 team members in 19 countries to provide innovative solutions. Together, we operate across the Americas, Europe, and India, working in close cooperation with over 3,000 clients in many of today's highest-growth industries.

CTG is an Equal Opportunity Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. CTG is fully committed to promoting employment opportunities for members of protected classes.