Epic PB Claims

Epic Professional Billing Claims Build Analyst

CTG is seeking a certified Epic Professional Billing (PB) Claims Build Analyst with 3+ years of hands-on build experience to support the design, configuration, and optimization of Epic billing and claims workflows. The ideal candidate will have strong expertise in PB claims processing, reimbursement workflows, and revenue cycle operations, with the ability to translate business requirements into effective system solutions. This role will work closely with revenue cycle stakeholders, operational leadership, and cross-functional IT teams to ensure accurate, compliant, and efficient claims processing.

Key Responsibilities:

• Design, build, configure, and maintain Epic PB claims functionality in alignment with organizational and regulatory requirements
• Collaborate with revenue cycle stakeholders to gather requirements and translate them into system build and workflow improvements
• Support claims processing workflows, including edits, scrubbing, submission, and denial management
• Participate in system implementations, upgrades, and optimization initiatives
• Perform unit testing, integrated testing, and user acceptance testing (UAT) to ensure system quality and performance
• Troubleshoot system issues, perform root cause analysis, and implement sustainable solutions
• Maintain thorough documentation of build decisions, workflows, and change management activities
• Support go-live and post-go-live stabilization efforts, including issue resolution and on-call support as needed
• Ensure compliance with payer requirements, regulatory standards, and Epic best practices
• Partner with reporting and analytics teams to support claims-related reporting and performance monitoring

Required Qualifications:

• Epic Professional Billing (PB) Certification (required)
• 3+ years of Epic PB build experience, with a focus on claims configuration and optimization
• Strong understanding of revenue cycle operations, including claims processing, reimbursement, and denial management
• Experience with system upgrades, enhancements, and testing cycles
• Proven ability to troubleshoot complex billing and claims issues
• Strong communication skills and ability to collaborate with both technical and operational stakeholders
• Excellent verbal and written English communication skills and the ability to interact professionally with a diverse group are required.