We are seeking an experienced Ambulatory Biller (Epic) to support full-cycle hospital billing and revenue cycle operations. This role is responsible for ensuring accurate claim submission, timely follow-up, and maximum reimbursement for facility-based services. The ideal candidate has deep experience with CMS-1500 claim forms, payer guidelines, and hospital billing workflows.
Key Responsibilities
- Prepare, review, and submit CMS 1500 claims for clinic services
- Ensure accurate coding, billing data, and charge capture prior to claim submission
- Perform full-cycle billing, including claim edits, corrections, and resubmissions
- Conduct timely follow-up on unpaid or denied claims with insurance payers
- Investigate and resolve claim denials, underpayments, and rejections
- Work closely with coding, clinical, and revenue cycle teams to resolve discrepancies
- Ensure compliance with federal, state, and payer-specific billing regulations
- Maintain productivity and quality standards for billing accuracy and turnaround time
- Document account activity and updates in billing systems
Qualifications
Required
- 2+ years of hospital/facility billing experience
- Strong experience working with CMS-1500 claim forms
- Experience working in Epic Resolute - Specifically Professional Billing
- Knowledge of revenue cycle management (RCM) processes
- Experience with commercial, Medicare, and Medicaid payers
- Familiarity with claim submission, denials, and appeals processes
- High attention to detail and accuracy
Preferred
- Experience with EHR/billing systems such as Epic Professional Billing
- Prior experience in high-volume billing environments
