RCM Systems Analyst

Spire Orthopedic Partners • Stamford, CT

2d • Onsite

About The Position

The Systems Analyst is responsible for the execution, maintenance, and support of system configurations, payer setups, and claim processing functions to ensure accurate and efficient revenue cycle operations. This role focuses on system execution, issue resolution, and data support, ensuring that system functionality aligns with defined workflows and operational requirements.

Requirements

• 3–5+ years of experience in revenue cycle operations or healthcare systems support
• Experience with practice management systems (e.g., athenahealth, ModMed, or similar)
• Understanding of: Claims processing lifecycle
• Understanding of: Basic payer requirements
• Understanding of: Billing and reimbursement workflows
• Strong organizational and problem-solving skills
• Proficiency in Excel and reporting tools
• Experience with clearinghouse and claim submission processes
• Familiarity with systems like ModMed or athenahealth

Responsibilities

• Build and maintain claim edits and system rules as directed
• Monitor and resolve clearinghouse rejections and submission issues
• Ensure required claim attachments and payer-specific requirements are met
• Identify recurring issues and escalate patterns for further review
• Maintain payer records, billing configurations, and system setup
• Load and update fee schedules and reimbursement tables
• Validate payer setup accuracy and resolve configuration related issues
• Support investigation of payment discrepancies tied to system setup
• Run and maintain standard operational and financial reports as directed
• Validate data accuracy and identify discrepancies
• Support reporting requests from RCM leadership and operational teams
• Assist in maintaining consistency of report outputs
• Investigate and resolve system and claim related issues
• Perform initial issue analysis and document findings
• Escalate complex or high impact issues to senior resources
• Track and monitor issue resolution through completion
• Submit and manage tickets with vendors, clearinghouses, and IT teams
• Follow up on open issues to ensure timely resolution
• Maintain payer portal access and support related activities
• Coordinate resolution of system-related issues with external partners
• Execute test scenarios for system updates and configuration changes
• Validate outcomes against expected results
• Document testing results and report issues identified
• Support implementation of approved system changes
• Manage intake and tracking of system related requests
• Prioritize tasks based on defined guidelines
• Provide status updates to stakeholders
• Maintain organized tracking of requests and resolutions
• Support user access requests and account maintenance
• Perform routine system updates and data maintenance
• Assist with system configuration updates as directed
• Maintain system documentation and reference materials

Benefits

• health
• dental
• vision
• 401(k)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED