Overview
CTG is seeking to fill an Epic HB/HB Claims Analyst position for our client.
Location: San Mateo, CA (Remote, up to 6 days of onsite required per month for this role)
Duration: 6 months
Position Summary
We are seeking an experienced Epic HB (Hospital Billing) / HB Claims Analyst to support the Phase 2 Epic implementation for our client on the West Coast. This role will play a critical part in designing, building, testing, and deploying HB and claims workflows, ensuring accurate billing, compliance, and efficient revenue cycle operations.
Key Responsibilities
Implementation & Build
- Lead and support the design, build, and configuration of Epic Hospital Billing (HB) and HB Claims modules
- Translate business requirements into functional system design
- Configure charge capture, claim edits, workqueues, and billing rules
- Collaborate with operational stakeholders to align workflows with system capabilities
Claims Management
- Build and maintain claims processing workflows, including claim generation, edits, and submission
- Configure electronic claims (837I), remittance processing (835), and payer-specific rules
- Troubleshoot claim rejections and denials, and implement solutions to reduce errors
Testing & Validation
- Develop and execute test plans, scripts, and scenarios (unit, integrated, and user acceptance testing)
- Validate system functionality to ensure accurate billing and claims output
- Support issue resolution and defect tracking
Go-Live & Support
- Provide go-live support, including command center participation
- Troubleshoot real-time issues related to HB billing and claims
- Assist in system stabilization and optimization post-implementation
Reporting & Compliance
- Ensure compliance with regulatory requirements and payer guidelines (CMS, HIPAA billing standards)
- Support reporting needs related to billing performance, claim status, and denial trends
- Partner with compliance and revenue integrity teams
Collaboration
- Work closely with Epic application teams, IT, revenue cycle leadership, and third-party vendors
- Participate in cross-functional design sessions and workflow reviews
Required Qualifications
- Epic HB certification (required)
- Strong understanding of hospital revenue cycle workflows and claims lifecycle
- Experience with claim edits, billing rules, and workqueue configuration
- Knowledge of EDI transactions (837I, 835) and clearinghouse processes
- Experience with multiple integrations and clearinghouses
- Knowledge of denial management and revenue integrity processes
- Experience with reporting tools (Epic Reporting Workbench, Clarity, Caboodle)
- Strong analytical, problem-solving, and communication skills
- Familiarity with regulatory requirements (CMS, HIPAA billing guidelines)
Experience:
- 5+ years of certified experience with Epic Hospital Billing (HB) and HB Claims
- At least one full Epic implementation experience required
- Hands-on experience supporting Epic HB build, testing, and production support activities
- Demonstrated experience in claims processing workflows, billing optimization, and denial reduction initiatives
Education:
- Associates Degree / College Diploma required
Certification Requirements:
- Epic HB / HB Claims certification required
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.
To Apply:
To be considered, please apply directly to this requisition using the link provided. For additional information, please contact Emily Drew at Emily.Drew@ctg.com. Kindly forward this to any other interested parties. Thank you!
The expected base salary for this position ranges from $75.00 to $85.00/hour. 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.