BILLING CLAIMS & ELECTRONIC REMITTANCE ANALYST

Epic Billing Claims & Electronic Remittance Analyst – Job Description

Position Summary

The Epic Billing Claims and Electronic Remittance Analyst is responsible for the design, build, optimization, and support of Epic Revenue Cycle functionality related to claims submission, remittance advice (ERA), and payer connectivity. This role partners closely with Revenue Cycle, Patient Financial Services, IT, and external payers to ensure accurate, timely billing and reimbursement while supporting continuous optimization and regulatory compliance.

Application Build & Configuration

• Configure, support, and optimize Epic Billing Claims, Electronic Remittance (ERA), and related Revenue Cycle workflows.
• Build and maintain claim formats, payer edits, remittance routing, adjustment reason codes and posting logic.
• Support clearinghouse integrations and payer connectivity.
• Configure and troubleshoot ANSI X12 transactions (837, 835, 276/277, 999).
• Maintain payers-specific rules, claim edits, and remittance mapping.

Claims & Remittance Operations

• Troubleshoot claim rejections, denials and remittance posting issues.
• Analyze payer responses and identify root causes of claim failures or posting discrepancies.
• Support electronic payment posting, secondary billing and reconciliation processes.
• Partner with billing and follow-up teams to improve first-pass claim acceptance and payment accuracy.

Optimization & Reporting

• Participate in optimization initiatives to improve claims throughput, reimbursement accuracy and cash flow.
• Analyze workflows and recommend system enhancements aligned with Epic best practices.
• Develop and maintain reports and dashboards related to claims status, remittance posting and payer performance.
• Support system upgrades, patches and new Epic functionality related to billing and remittance.

Collaboration & Governance

• Collaborate with operational stakeholders, payers, clearinghouses, and vendor partners.
• Participate in governance groups, optimization committees, and project workgroups.
• Assist with testing (unit, integrated, and user acceptance testing) for Revenue Cycle changes.
• Provide end-user training, documentation, and ongoing support.

Compliance & Quality

• Ensure Epic build and workflows comply with regulatory requirements (CMS, HIPAA, payer rules).
• Support audits related to billing, claims, and remittance processing.
• Follow change management and documentation standards.

Qualifications

Required

• Strong analytical, problem‑solving, and troubleshooting skills.
• Excellent communication and customer service abilities.

Preferred

• Epic certification in Billing or willingness to obtain within 90 days.

Competencies

• Ability to translate billing workflows into technical Epic configuration.
• Strong attention to detail and commitment to documentation accuracy.
• Ability to work both independently and collaboratively with clinical teams.
• Strong organization, time management, and prioritization skills in a fast‑paced environment.
• Discretion and ability to manage PHI and sensitive patient information.
• Experience with Epic Hyperspace, Reporting Workbench, SmartTools, or clinical decision support is a plus.

Work Environment

• Standard office environment with hybrid or in‑office options based on organizational policy.
• Occasional after‑hours or on‑call support during upgrades, go‑lives, and critical clinical workflows.