Revenue Cycle Specialist

Job Summary:

Consultant Advisor, ERP Jessica Plemmons is recruiting this position.

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Our Los Angeles based client is seeking an experienced Epic Resolute Professional Billing Analyst to support healthcare revenue cycle operations, with a focus on claims management, insurance follow-up, denial resolution, payment posting, and patient billing. The ideal candidate will have hands-on Epic Resolute Professional Billing experience, a strong understanding of healthcare reimbursement processes, and the ability to investigate and resolve complex billing and payer-related issues. The duration is 6 months contract.

Responsibilities

• Support Epic Resolute Professional Billing workflows, including claims processing, workqueues, remittance, guarantor accounts, and patient billing.
• Manage insurance follow-up, accounts receivable, claim rejections, denials, appeals, and payment discrepancies.
• Review and interpret EOBs, ERAs, payer correspondence, denial notices, and clearinghouse rejections to determine appropriate resolution.
• Research payer requirements, reimbursement policies, timely filing guidelines, and appeal procedures.
• Work with Medicare, Medi-Cal, California Medicaid managed care plans, commercial insurers, workers' compensation, and third-party administrators.
• Apply knowledge of CPT, HCPCS, ICD-10-CM, modifiers, medical necessity, claim forms, and denial codes to support accurate billing and reimbursement.
• Identify recurring billing issues and collaborate with revenue cycle teams to improve collections, reduce denials, and optimize workflows.
• Support revenue cycle reporting, account research, and resolution of outstanding receivables.

Qualifications & Requirements

• Minimum of 2 years of healthcare revenue cycle, medical billing, accounts receivable, insurance follow-up, denial management, payment posting, patient billing, or business office experience.
• Hands-on Epic Resolute Professional Billing experience is required.
• Experience with Epic workqueues, claims, remittance, guarantor accounts, patient billing, and reporting workflows preferred.
• Experience working with Medicare, Medi-Cal, California Medicaid managed care plans, commercial insurance, workers' compensation, and third-party administrators.
• Strong understanding of EOBs, ERAs, payer portals, clearinghouse rejections, denial notices, appeals, timely filing requirements, and reimbursement policies.
• Working knowledge of CPT, HCPCS, ICD-10-CM, modifiers, medical necessity, payer reimbursement methodologies, claim forms, and denial codes.

Preferred Certifications

• Certified Professional Biller (CPB)
• Certified Coding Associate (CCA)
• Certified Professional Coder (CPC)
• Certified Revenue Cycle Representative (CRCR)
• Or equivalent healthcare billing or revenue cycle certification.

To learn more about this and other positions, contact Jessica Plemmons at 678-593-3331 or jessica.plemmons@healthcareitleaders.com. Healthcare IT Leaders is a national leader in IT workforce solutions, connecting healthcare provider, payer and life sciences organizations with experienced technology talent for consulting and full-time hiring. For more information, visit us on the web at www.healthcareitleaders.com.