[Remote] RCS Systems Senior Analyst

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.ResponsibilitiesDesign, build, test, and deploy TES edits, edit groups, and workfilesAssign and validate TES edits across test and production environmentsDevelop and implement BAR claim edits, claim logic, and statement controlsEnsure accuracy, compliance, and efficiency of revenue cycle billing logicDesign, 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 continuitySupport athenaIDX Anesthesia module configuration and workflows, including: Charge capture and time-based billing, Documentation alignment and regulatory compliance requirementsDevelop 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 workflowsMonitor and resolve claim transmission failures, rejections, and remit discrepanciesSupport setup, testing, and maintenance of payer connections and EDI trading partnersEnsure compliance with X12 standards and payer-specific requirementsCoordinate with clearinghouses and vendors to resolve file processing and transmission issuesSupport SIU and API interfaces for: ADT feeds (patient demographics), Charge interfaces and upstream clinical system integrations with athenaIDXEnsure data accuracy and integrity across end-to-end revenue cycle workflowsSkillsDesign, build, test, and deploy TES edits, edit groups, and workfilesAssign and validate TES edits across test and production environmentsDevelop and implement BAR claim edits, claim logic, and statement controlsEnsure accuracy, compliance, and efficiency of revenue cycle billing logicDesign, develop, and support athenaIDX ETM workflows and automationCreation and maintenance of ETM Agents and workflow triggersAutomation of task routing, work queues, and exception handlingMonitoring and optimization of workflow performance and throughputTroubleshooting ETM process failures and ensuring operational continuitySupport athenaIDX Anesthesia module configuration and workflowsCharge capture and time-based billingDocumentation alignment and regulatory compliance requirementsDevelop and maintain Anesthesia-specific TES edits and BAR logicSupport EDI clearinghouse operations and integrationsEligibility (270/271), Claim submissions (837), and Remittance processing (835 ERA)Manage and troubleshoot ERA (835) exchanges and posting workflowsMonitor and resolve claim transmission failures, rejections, and remit discrepanciesSupport setup, testing, and maintenance of payer connections and EDI trading partnersEnsure compliance with X12 standards and payer-specific requirementsCoordinate with clearinghouses and vendors to resolve file processing and transmission issuesSupport SIU and API interfaces for ADT feeds (patient demographics)Charge interfaces and upstream clinical system integrations with athenaIDXEnsure data accuracy and integrity across end-to-end revenue cycle workflowsBenefitsMedical dental, vision insuranceA 401(k) plan with a company matchPaid time off and holidaysProfessional development supportEmployee wellness resourcesCompany OverviewSCP Health is a healthcare-based agency that comprises a physician-led team of clinical and operational experts. It was founded in 1994, and is headquartered in Atlanta, Georgia, US, with a workforce of 5001-10000 employees. Its website is https://www.scphealth.com.Company H1B SponsorshipSCP Health has a track record of offering H1B sponsorships, with 8 in 2025, 29 in 2024, 2 in 2023, 4 in 2022, 3 in 2021, 2 in 2020. Please note that this does not guarantee sponsorship for this specific role.