Job Details

Senior Professional Billing and Claims Consultant

This is a Remote role.

Compensation: $50-$55 / HR

Contract Length: 5 Months

Hours: Full-Time

Start Date: ASAP

ABOUT THE ROLE

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.
WHAT YOU'LL DO

• 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

• 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