CAH Biller – Epic (Critical Access Hospital Billing Specialist)

We are seeking an experienced Critical Access Hospital (CAH) Biller with strong Epic expertise to support full-cycle facility billing and reimbursement. This role is responsible for managing UB-04 claims in a CAH environment, with a focus on Medicare cost-based reimbursement, claim accuracy, and timely follow-up. The ideal candidate has hands-on experience billing for CAHs, understands the nuances of Medicare reimbursement methodologies, and is proficient in Epic billing workflows. Key Responsibilities - Prepare, review, and submit UB-04 (CMS-1450) claims for Critical Access Hospital services - Utilize Epic (Resolute Hospital Billing) to manage claims, work queues, and billing edits - Ensure accurate billing aligned with CAH cost-based reimbursement guidelines - Review and resolve claim edits, rejections, and denials within Epic work queues - Perform timely follow-up on unpaid or underpaid claims, particularly Medicare accounts - Analyze remittance advice (RA) and Explanation of Benefits (EOBs) to resolve discrepancies - Collaborate with coding, clinical, and revenue cycle teams to ensure billing accuracy - Maintain compliance with CMS regulations and CAH-specific billing requirements - Document account activity and maintain detailed notes within Epic Qualifications Required - 2+ years of hospital/facility billing experience, preferably in a CAH setting - Hands-on experience with Epic Resolute Hospital Billing - Strong knowledge of UB-04 claim forms - Experience with Medicare billing, especially CAH cost-based reimbursement - Proven ability to resolve denials, edits, and payment variances - High attention to detail and accuracy Preferred - Experience with Medicare Part A billing and reimbursement methodologies - Familiarity with other payer types (Medicaid, commercial) - Understanding of ICD-10, CPT, and HCPCS coding (facility-side) - Experience working in a remote, high-volume production environment