Note: The job is a remote job and is open to candidates in USA. SCP Health is a leader in clinical practice management, focusing on enhancing clinical effectiveness across various healthcare services. They are seeking a RCS Systems Senior Analyst to design, build, and support various applications and workflows related to revenue cycle management, ensuring compliance and efficiency in billing processes.

Responsibilities

• Design, build, test, and deploy TES edits, edit groups, and workfiles
• Assign and validate TES edits across test and production environments
• Develop and implement BAR claim edits, claim logic, and statement controls
• Ensure accuracy, compliance, and efficiency of revenue cycle billing logic
• Design, develop, and support athenaIDX ETM workflows and automation, including: Creation and maintenance of ETM Agents and workflow triggers, Automation of task routing, work queues, and exception handling, Monitoring and optimization of workflow performance and throughput, Troubleshooting ETM process failures and ensuring operational continuity
• Support athenaIDX Anesthesia module configuration and workflows, including: Charge capture and time-based billing, Documentation alignment and regulatory compliance requirements
• Develop and maintain Anesthesia-specific TES edits and BAR logic (e.g., modifiers, unit calculations, concurrency rules)
• Support EDI clearinghouse operations and integrations, including: Eligibility (270/271), Claim submissions (837), and Remittance processing (835 ERA)
• Manage and troubleshoot ERA (835) exchanges and posting workflows
• Monitor and resolve claim transmission failures, rejections, and remit discrepancies
• Support setup, testing, and maintenance of payer connections and EDI trading partners
• Ensure compliance with X12 standards and payer-specific requirements
• Coordinate with clearinghouses and vendors to resolve file processing and transmission issues
• Support SIU and API interfaces for: ADT feeds (patient demographics), Charge interfaces and upstream clinical system integrations with athenaIDX
• Ensure data accuracy and integrity across end-to-end revenue cycle workflows

Skills

• Design, build, test, and deploy TES edits, edit groups, and workfiles
• Assign and validate TES edits across test and production environments
• Develop and implement BAR claim edits, claim logic, and statement controls
• Ensure accuracy, compliance, and efficiency of revenue cycle billing logic
• Design, develop, and support athenaIDX ETM workflows and automation
• Creation and maintenance of ETM Agents and workflow triggers
• Automation of task routing, work queues, and exception handling
• Monitoring and optimization of workflow performance and throughput
• Troubleshooting ETM process failures and ensuring operational continuity
• Support athenaIDX Anesthesia module configuration and workflows
• Charge capture and time-based billing
• Documentation alignment and regulatory compliance requirements
• Develop and maintain Anesthesia-specific TES edits and BAR logic
• Support EDI clearinghouse operations and integrations
• Eligibility (270/271), Claim submissions (837), and Remittance processing (835 ERA)
• Manage and troubleshoot ERA (835) exchanges and posting workflows
• Monitor and resolve claim transmission failures, rejections, and remit discrepancies
• Support setup, testing, and maintenance of payer connections and EDI trading partners
• Ensure compliance with X12 standards and payer-specific requirements
• Coordinate with clearinghouses and vendors to resolve file processing and transmission issues
• Support SIU and API interfaces for ADT feeds (patient demographics)
• Charge interfaces and upstream clinical system integrations with athenaIDX
• Ensure data accuracy and integrity across end-to-end revenue cycle workflows

Benefits

• Medical dental, vision insurance
• A 401(k) plan with a company match
• Paid time off and holidays
• Professional development support
• Employee wellness resources

Company Overview

Company H1B Sponsorship