Epic Revenue Cycle Analyst - PB Contracting, Claims, and Remittance

Computer Task Group, Inc

NY

JOB DETAILS
SALARY
$120,000–$130,000 Per Year
SKILLS
American National Standards Institute (ANSI), Auditing, Automation, Billing, Business Solutions, Cash Flow, Claims Processing, Clinical Information Systems, Co-Payments, Communication Skills, Compensation and Benefits, Contract Analysis, Contract Management, Documentation, Electronic Data Interchange (EDI), English Language, Epic OpTime (Operating Room), Epic Resolute (Patient Accounting), Epic Systems, Federal Laws and Regulations, Fee Schedule, Finance, Health Informatics, Insurance, Legal, Network Routers, Operational Audit, Presentation/Verbal Skills, Primary Care, Product Requirements Document (PRD), Regulations, Reimbursement, Revenue Analysis, SQL (Structured Query Language), Semantic Reasoner, Simulation, State Laws and Regulations, Test Design, Writing Skills
LOCATION
NY
POSTED
12 days ago

CTG is seeking an experienced Revenue Cycle Analyst - PB Contracting, Claims, and Remittance. The Epic Proration and Contracting Analyst acts as the primary architect bridging healthcare finance and clinical configuration. This technical role is responsible for translating complex legal payer contracts, fee structures, and regulatory reimbursement policies into highly precise system automation within Epic Resolute Professional Billing (PB). By designing, testing, and maintaining contract portfolios and configuring outbound claims and inbound electronic remittance automation, this position maximizes cash flow, eliminates zero-balance blind spots, and engineers systemic solutions to automatically catch and mitigate insurance underpayments and denials. Skills Inventory Epic Core Application Build (PB) Epic Master Files: Proficient in configuring and linking Contract (CPD), Fee Schedule (FSC), and Procedure (EAP) master files. Proration Logic: Mastery of configuring dynamic pre-claim proration to split complex financial liabilities between Payer Allowance and Patient Responsibility (copay, coinsurance, deductible). Charge Routing Integration: Deep understanding of Epic Charge Router mechanisms to ensure accurate charge flows from clinical applications (EpicCare, OpTime) into the PB engine. Lessor-Of Configuration: Expertise in writing logic comparing billed charges against allowable rates to calculate precise expected reimbursement values. Claims & Remittance Automation EDI Frameworks: Thorough knowledge of electronic data interchange processing and technical layout configurations. Outbound Claims (837P): Expert capability in mapping and formatting professional billing charges into compliant ANSI X12 837P data streams. Inbound Remittance (835): Advanced configuration of Electronic Remittance Advice (ERA) parsing and automated posting logic. CARC/RARC Mapping: Specialized skill in mapping Claim Adjustment Reason Codes and Remittance Advice Remark Codes to drive automated billing actions. Revenue Protection & Denial Mitigation Variance Auditing: Advanced design of variance tolerance thresholds to identify discrepancies where Payer Allowed Amounts fall below Epic Expected Reimbursement. Epic Rules Engine (CER / PAF): Mastery in writing complex, context-specific CER and PAF criteria to identify contract violations and isolate root-cause denials. Workqueue (WQ) Engineering: Experience structuring specialized Contract Variance and Remittance Follow-Up Workqueues to segregate financial disputes from daily billing operational queues. Bulk Appeal Routing: Implementation of single-click automated Follow-Up Activities to package dispute letters and appeal documentation directly from the user workspace. Testing, Analytics & Data Operations Remittance Simulation: Proven track record of executing mock 835 cycles in Sandbox/Test (TST) environments to validate newly built contract portfolios prior to Production (PRD) deployment. SQL & Chronicles Reporting: Ability to run targeted audits on Chronicles data, identifying systemic payer patterns regarding underpayments and claim rejections. 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. Kindly forward this to any other interested parties. Thank you! The expected base salary for this position ranges from $120,000 to $130,000. 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. About CTG CTG, a Cegeka company, delivers IT and business solutions that enhance clients' digital agility, empowering them to seize new opportunities and overcome any challenge. Backed by more than 60 years' experience and a commitment to being a reliable, results-driven partner, we work shoulder to shoulder with clients to shape digital together. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. With more than 9,000 team members in over 15 countries, we combine global expertise with local insight to deliver innovative solutions. We operate across the Americas, Europe, and India, working with over 3,000 clients in many of today's highest-growth industries. Together, we shape what's next-working shoulder to shoulder to deliver impactful solutions for our clients and society. Our culture is built by the people who work at CTG, the values we hold, and the actions we take. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. At CTG, you'll find a workplace where you are encouraged to grow, supported in your ambitions, and empowered to shape your own career journey. For more information, visit www.ctg.com. CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws. CTG is an Equal Opportunity Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. CTG is fully committed to promoting employment opportunities for members of protected classes.

About the Company

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Computer Task Group, Inc

CTG (NASDAQ: CTG) provides industry-specific IT services and solutions that address the business needs and challenges of clients in high-growth industries in North America and Western Europe. CTG also provides strategic staffing services for major technology companies and large corporations. Backed by more than 50 years of experience and proprietary methodologies, CTG has a proven track record of reliably delivering high-value, industry-specific staffing services and solutions to its clients. CTG has operations in North America, Western Europe, and India.

CTG's greatest asset is its people, and as such, we are committed to providing employees programs and processes to support their performance, hone their skills, and advance in their careers. This commitment is reflected by CTG being named a Best Places to Work in Healthcare company by Modern Healthcare (2013-2016) in North America, and a Best Workplace in the United Kingdom (2013), Belgium (since 2007), and Luxembourg (since 2011).

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity/Affirmative Action Employer and strong advocate of workforce diversity. Minority/Female/Sexual Orientation/Gender Identity/Disability/Veteran.
COMPANY SIZE
2,500 to 4,999 employees
INDUSTRY
Computer/IT Services
FOUNDED
1966
WEBSITE
http://www.ctg.com/