Epic Resolute - PB Claims Biller

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Epic Resolute - PB Claims Biller based in the United States. This remote role supports the end-to-end billing of professional and ambulatory healthcare claims. You will prepare, submit, monitor, and resolve claims with third-party insurance carriers. The position plays an important role in maximizing reimbursement and reducing billing errors and delays. You will work closely with billing leadership, healthcare organizations, and payer representatives. The role requires strong knowledge of Epic, full-cycle physician billing, coding, and denial management. Success depends on accuracy, timely follow-up, effective communication, and the ability to manage competing priorities. This is an opportunity to contribute directly to efficient revenue cycle operations in a healthcare-focused environment.

Prepare and submit hospital-based physician, professional, and clinic claims to third-party insurance carriers through electronic or paper billing channels. Secure and review required medical documentation and respond to information requests from insurance payers. Monitor unpaid claims and conduct timely follow-up until payment is received or the remaining balance becomes self-pay. Identify and correct billing errors, process claim rejections, and resubmit corrected claims to support accurate and timely reimbursement. Review and interpret Explanation of Benefits (EOBs), payer inquiries, denial information, and reimbursement issues. Manage claim denials and appeals, working with insurance companies to support maximum appropriate reimbursement. Review late-charge reports and submit corrected claims or process write-offs in accordance with applicable client policies. Review readmission and overlapping-service reports and determine whether claims should be ignored, merged, or split based on payer rules and client requirements. Review payer-related credit reports, resolve eligible credits, and provide required credit listings to healthcare facilities. Maintain daily claim submission targets with a strong focus on accuracy and a goal of zero errors. Collaborate with billing managers and supervisors to resolve reimbursement challenges, billing obstacles, and complex account issues. Maintain confidentiality of patient and customer information and comply with applicable healthcare privacy and regulatory requirements. Consistently meet production, quality assurance, customer service, and client-specific performance standards. Participate in team projects, professional development activities, and other billing-related initiatives as assigned. Requirements At least 3 years of full-cycle physician or ambulatory billing experience is required. At least 2–3 years of recent PB Epic experience is required, with hands-on familiarity with professional billing workflows. Experience with CPT and ICD-10 coding and a solid understanding of medical terminology. Demonstrated experience communicating with multiple insurance payers and resolving claim-related inquiries. Experience filing and managing claim appeals to support appropriate reimbursement. Strong computer skills and the ability to work efficiently with billing and healthcare information systems. Strong written and verbal communication skills, with the ability to interact professionally with internal teams, clients, and payer representatives. Excellent attention to detail and a commitment to accurate, timely claim submission and follow-up. Ability to multitask, prioritize workloads, and maintain productivity and quality standards in a deadline-driven environment. Ability to work effectively with high-profile customers and navigate complex client-specific billing processes. Demonstrated discretion when handling confidential information and familiarity with healthcare privacy requirements. Ability to interpret payer requirements, identify billing obstacles, and independently pursue appropriate resolutions. Benefits Compensation: $24–$26 per hour, with pay determined by factors such as market conditions, location, education, experience, and certifications. Remote work: Fully remote position within the United States. Opportunity to contribute to professional and ambulatory healthcare revenue cycle operations. Ongoing opportunities to develop billing and revenue cycle knowledge through company-provided education. Collaborative environment involving billing leadership, healthcare organizations, and insurance payers. Exposure to complex claims, denial management, reimbursement, and payer-specific billing processes. Equal employment opportunity workplace with consideration for candidates regardless of legally protected characteristics. Benefits and eligibility may vary according to applicable employment terms and location.

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