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CAH Biller – Epic (Critical Access Hospital Billing Specialist)

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Before you apply
SeniorityMid
Experience2+ yrs
Company size501–1,000 people
PostedMar 31, 2026 · 7mo ago
Verified live2d ago
May no longer be actively hiring
Posted by the company on Mar 31, 202647% of this company's open roles have been listed for 90+ days
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At a glanceSummarised by Seekless from the posting.
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
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
Skills
Epic
Resolute Hospital Billing
UB-04
Medicare
CAH billing
ICD-10
CPT
HCPCS
About the role
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
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Utilize Epic (Resolute Hospital Billing) to manage claims, work queues, and billing edits
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Ensure accurate billing aligned with CAH cost-based reimbursement guidelines
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Review and resolve claim edits, rejections, and denials within Epic work queues
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Perform timely follow-up on unpaid or underpaid claims, particularly Medicare accounts
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Analyze remittance advice (RA) and Explanation of Benefits (EOBs) to resolve discrepancies
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Collaborate with coding, clinical, and revenue cycle teams to ensure billing accuracy
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Maintain compliance with CMS regulations and CAH-specific billing requirements
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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