Position Overview:
The RCM Systems Analyst plays a key technical and analytical role within Revenue Cycle Operations, responsible for ensuring that RCA's electronic health record (EHR) billing configuration, charge capture, and data integrations function accurately and efficiently. This position combines revenue-cycle knowledge with strong technical proficiency to maintain system integrity, streamline automation, and support data-driven decision-making.
The RCM Systems Analyst plays a key technical and analytical role within Revenue Cycle Operations, responsible for ensuring that RCA's electronic health record (EHR) billing configuration, charge capture, and data integrations function accurately and efficiently. This position combines revenue-cycle knowledge with strong technical proficiency to maintain system integrity, streamline automation, and support data-driven decision-making.
The ideal candidate is detail-oriented, systems-focused, and capable of bridging the gap between IT, billing, and operations. They will analyze complex data sets, troubleshoot EHR workflows, and optimize interfaces that support clean claim submission and timely reimbursement.
Key Responsibilities:
* Configure, maintain, and validate EHR billing system settings, including service codes, fee schedules, payers, and charge mapping
* Administer and audit the Charge Description Master (CDM) to ensure full compliance with federal, state, and payer guidelines
* Manage and validate EDI transactions (837, 835, 277, 270/271) to ensure accurate claim creation, transmission, and remittance posting
* Develop and run SQL or database queries to extract data for troubleshooting, reconciliation, and performance analytics
* Support integration between the EHR and external systems such as clearinghouses, accounting platforms, and payer portals
* Participate in EHR system upgrades, patches, and testing, with a focus on billing logic, data integrity, and automation validation
* Collaborate with IT and Revenue Cycle leadership to design and implement new system enhancements that improve efficiency and compliance
* Analyze root causes of billing or posting errors using system logs, interface data, and transaction reports; document and escalate findings as appropriate
* Support month-end close by validating system batches, reconciling billing data, and ensuring transactional accuracy
* Maintain detailed documentation of EHR build decisions, configurations, and workflow standards
* Manage tickets and service requests within established SLA timelines, tracking resolution and identifying recurring system issues
* Participate in process-improvement projects focused on automation, data integrity, and system integration
* Assist with internal and external audits, providing technical data extracts, reports, and traceability documentation
* Configure, maintain, and validate EHR billing system settings, including service codes, fee schedules, payers, and charge mapping
* Administer and audit the Charge Description Master (CDM) to ensure full compliance with federal, state, and payer guidelines
* Manage and validate EDI transactions (837, 835, 277, 270/271) to ensure accurate claim creation, transmission, and remittance posting
* Develop and run SQL or database queries to extract data for troubleshooting, reconciliation, and performance analytics
* Support integration between the EHR and external systems such as clearinghouses, accounting platforms, and payer portals
* Participate in EHR system upgrades, patches, and testing, with a focus on billing logic, data integrity, and automation validation
* Collaborate with IT and Revenue Cycle leadership to design and implement new system enhancements that improve efficiency and compliance
* Analyze root causes of billing or posting errors using system logs, interface data, and transaction reports; document and escalate findings as appropriate
* Support month-end close by validating system batches, reconciling billing data, and ensuring transactional accuracy
* Maintain detailed documentation of EHR build decisions, configurations, and workflow standards
* Manage tickets and service requests within established SLA timelines, tracking resolution and identifying recurring system issues
* Participate in process-improvement projects focused on automation, data integrity, and system integration
* Assist with internal and external audits, providing technical data extracts, reports, and traceability documentation
Required Qualifications:
* Bachelor's degree in Computer Science, Business, Healthcare Administration, or related field, or 5+ years of equivalent experience
* Proven experience in healthcare revenue cycle system administration, EHR configuration, or technical billing support
* Proficiency with Excel (pivot tables, v-lookups, data analysis) and ability to write or interpret SQL queries
* Understanding of ANSI X12 standards and file structure for EDI transactions (837, 835, 277, 270/271)
* Strong analytical and problem-solving skills with attention to data accuracy and process integrity
* Experience with ticketing or issue-tracking systems (e.g., ServiceNow, Jira, ManageEngine)
* Excellent verbal and written communication skills for translating technical findings into business language
* Bachelor's degree in Computer Science, Business, Healthcare Administration, or related field, or 5+ years of equivalent experience
* Proven experience in healthcare revenue cycle system administration, EHR configuration, or technical billing support
* Proficiency with Excel (pivot tables, v-lookups, data analysis) and ability to write or interpret SQL queries
* Understanding of ANSI X12 standards and file structure for EDI transactions (837, 835, 277, 270/271)
* Strong analytical and problem-solving skills with attention to data accuracy and process integrity
* Experience with ticketing or issue-tracking systems (e.g., ServiceNow, Jira, ManageEngine)
* Excellent verbal and written communication skills for translating technical findings into business language
Preferred Qualifications:
* Experience supporting EHR systems such as Netsmart, Cerner, Epic, or similar platforms
* Background in behavioral health or addiction treatment billing environments
* Familiarity with API integrations, data imports/exports, and automation tools
* Understanding of HIPAA, CMS, and managed-care billing and compliance standards
* Experience supporting EHR systems such as Netsmart, Cerner, Epic, or similar platforms
* Background in behavioral health or addiction treatment billing environments
* Familiarity with API integrations, data imports/exports, and automation tools
* Understanding of HIPAA, CMS, and managed-care billing and compliance standards
Travel:
Travel is not typically required for this role, however, out of state or site travel may be requested as necessary.
Travel is not typically required for this role, however, out of state or site travel may be requested as necessary.
Non-Discrimination Statement:
It is the policy of Recovery Centers of America (RCA) to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, age, disability, marital status, citizenship, genetic information, or any other characteristic protected by law.
It is the policy of Recovery Centers of America (RCA) to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, age, disability, marital status, citizenship, genetic information, or any other characteristic protected by law.
State Specific Responsibilities:
Follows organizational cybersecurity policies, including acceptable use, password management, and multi-factor authentication requirements. Immediately reports suspected security incidents, unauthorized access, or data breaches in accordance with company policy and regulatory requirements. Maintains strict confidentiality of PHI and adheres to the principle of least privilege, accessing only the minimum necessary data required to perform job functions.
Follows organizational cybersecurity policies, including acceptable use, password management, and multi-factor authentication requirements. Immediately reports suspected security incidents, unauthorized access, or data breaches in accordance with company policy and regulatory requirements. Maintains strict confidentiality of PHI and adheres to the principle of least privilege, accessing only the minimum necessary data required to perform job functions.