Senior Epic Professional Billing (PB) Consultant - Claims & Reimbursement

Job title: Senior Epic Professional Billing (PB) Consultant - Claims & Reimbursement

Location: Remote

Duration: 3 months

Pay: $70 - $85 /hr W2 only (MUST be a US Citizen)

MUST be certified in both Epic Professional Billing (PB) and PB Claims

Summary: The client is seeking seasoned and dynamic Senior Epic Professional Billing (PB) Consultants with specialized expertise in PB Claims and Reimbursement Contracts. As core members of our healthcare revenue cycle consulting practice, you will lead complex implementations, optimization initiatives, and back-end revenue cycle transformations for major healthcare provider organizations. We are looking for experts who can independently design, build, and optimize professional billing, claims processing, and complex managed care reimbursement structures to maximize financial performance and revenue integrity.

Key Responsibilities

• Billing & Claims Optimization: Lead the end-to-end design, build, validation, and implementation of Epic PB and PB Claims workflows, ensuring clean claim submission, efficient clearinghouse integration, and streamlined remittance processing.
• Reimbursement Contract Management: Configure, maintain, and test complex reimbursement contracts, fee schedules, and contract modeling structures to support accurate expected payment calculations and variance analysis.
• Denial & Revenue Lifecycle Management: Partner with billing leadership, financial teams, and clinical departments to analyze denial trends, resolve claim edit bottlenecks, and implement automated rules to reduce accounts receivable days.
• Requirements & Cross-Functional Collaboration: Translate complex financial and administrative requirements into scalable system configurations, bridging the gap between technical teams and revenue cycle leadership.
• Testing & Quality Assurance: Design comprehensive test scripts, execute integrated billing and claims testing cycles, and oversee system validation during major upgrades or new provider group onboarding.
• Leadership & Knowledge Transfer: Act as senior subject matter experts, guiding client stakeholders through financial workflow transformations, mentoring junior analysts, and sharing industry best practices across the project lifecycle.

Qualifications

• Minimum of 5 to 7 years of hands-on Epic configuration, implementation, and optimization experience specializing in Epic Professional Billing (PB).
• Current, active Epic Professional Billing (PB) and PB Claims certifications.
• Proven track record of configuring and managing complex reimbursement contracts, managed care contracts, and fee schedules within Epic.
• Extensive experience delivering revenue cycle transformations within large hospital networks, physician practice groups, integrated delivery networks (IDNs), or complex health systems.
• Comprehensive understanding of physician billing regulations, clearinghouse operations, electronic remittance advice (ERA), and revenue cycle key performance indicators (KPIs).