Senior Revenue Cycle Management Systems Analyst

ICBD • Fort Lauderdale, FL

2d • Onsite

About The Position

The Senior Revenue Cycle Management Systems Analyst — RCM is a senior technical and functional individual contributor responsible for the implementation, administration, integration, and ongoing optimization of the organization's revenue cycle management technology stack — with CollaborateMD as the primary platform. This role bridges the gap between healthcare operations and technology: the ideal candidate is equally comfortable configuring billing workflows inside an RCM platform, writing API-based integrations, extracting and analyzing claims data via SQL, and sitting across the table from a billing director to map out a process improvement.
This is not an entry-level or purely functional role. We are looking for someone who has worked inside a real RCM environment — who understands the revenue cycle from patient registration through claim submission, adjudication, ERA posting, and denial management — and who can translate that domain knowledge into system configurations, integrations, and technical solutions. Experience with CollaborateMD is strongly preferred; candidates with deep expertise in comparable platforms (Kareo, AdvancedMD, athenahealth, or similar) will also be considered.
A defining expectation of this role is healthcare interoperability: this analyst will own and maintain integrations between the RCM platform and adjacent systems — EHR/EMR platforms, clearinghouses, payer portals, and internal data pipelines — using HL7, FHIR, X12 EDI, and API-based standards. The analyst will also take ownership of system implementations and enhancement projects from requirements through go-live, coordinating with clinical, billing, and IT stakeholders throughout.

Requirements

• 5+ years of hands-on experience in a Business Systems Analyst, RCM Systems Analyst, or similar technical role within a healthcare revenue cycle environment.
• Direct, production-level experience administering CollaborateMD or a comparable RCM platform (Kareo, AdvancedMD, athenahealth, Waystar, Epic Resolute, or similar); CollaborateMD experience strongly preferred.
• Deep understanding of the end-to-end revenue cycle: patient registration, insurance verification, eligibility, charge capture, claim submission, ERA/EOB processing, denial management, and patient billing.
• Demonstrated experience building and maintaining healthcare interoperability integrations using HL7 v2.x, FHIR R4, and X12 EDI standards (837, 835, 270/271, 276/277).
• Hands-on experience with clearinghouse platforms (Change Healthcare, Availity, Waystar, or similar) including claim submission, rejection management, and ERA processing.
• Experience with RESTful and/or SOAP API integrations; ability to read API documentation, write integration logic, and troubleshoot data exchange issues independently.
• Solid understanding of HIPAA regulations, PHI data handling requirements, and security controls relevant to healthcare IT systems.
• Strong requirements gathering, documentation, and communication skills — able to work effectively with RCM operations, clinical teams, Finance, and technical stakeholders.
• Experience leading or co-leading RCM system implementations or integration projects from requirements through go-live.

Nice To Haves

• Direct CollaborateMD administration experience, including payer setup, billing rules, ERA configuration, and reporting.
• Experience with Epic, athenahealth, eClinicalWorks, or other major EHR/EMR platforms and their RCM integration patterns.
• Familiarity with FHIR-based interoperability standards including SMART on FHIR, CDS Hooks, and Da Vinci implementation guides.
• Experience with payer-specific EDI requirements, enrollment processes, and ERA/EFT setup across commercial and government payers (Medicare, Medicaid, BCBS, UHC, Aetna, etc.).
• Knowledge of medical coding standards: CPT, ICD-10-CM/PCS, HCPCS, modifiers, and their impact on claim adjudication.
• Experience with prior authorization platforms (Availity, CoverMyMeds, or payer-native portals) and their integration with RCM workflows.
• Exposure to NetSuite ERP and RCM-to-ERP financial data flows for revenue, collections, and AR reconciliation.
• Experience in multi-specialty, multi-site, or high-volume ambulatory or hospital-based billing environments.
• Exposure to No Surprises Act compliance workflows, good faith estimates, or advanced explanation of benefits (AEOB) requirements.

Responsibilities

• Serve as the primary administrator for CollaborateMD (or equivalent RCM platform), with full ownership of system configuration, user management, role architecture, and environment governance.
• Configure and maintain core RCM platform settings including practice setup, provider enrollment, fee schedules, payer configurations, place of service codes, and billing rules.
• Manage charge capture configurations including CPT/ICD mapping, modifier rules, bundling logic, and provider-specific billing profiles.
• Administer ERA/EOB posting rules, payment variance thresholds, contractual adjustment mappings, and denial reason code routing.
• Coordinate platform upgrades, patch releases, and new module deployments; lead regression testing and UAT with RCM stakeholders.
• Maintain system documentation, configuration logs, and change management records in accordance with IT governance standards.
• Design, build, and maintain integrations between the RCM platform and external systems using HL7 v2.x (ADT, SIU, DFT, ORM, ORU), FHIR R4 APIs, and X12 EDI transaction sets (837, 835, 270/271, 276/277).
• Own and manage integrations between CollaborateMD and EHR/EMR platforms for patient demographics, encounter data, charge feed, and clinical documentation.
• Manage clearinghouse integrations including claim submission pipelines, acknowledgment processing (999/TA1), and rejection resolution workflows.
• Build and maintain payer portal integrations and automated eligibility verification workflows, including real-time and batch 270/271 transactions.
• Maintain the integration between CollaborateMD and NetSuite ERP for payment posting, revenue recognition, and financial reconciliation data flows.
• Develop and maintain RESTful and SOAP API connections; write and maintain integration scripts, transformation logic, and data mapping specifications.
• Monitor integration performance, implement alerting, and manage exception handling and reprocessing workflows to ensure data completeness and accuracy.
• Configure and optimize end-to-end RCM workflows including patient registration, insurance verification, prior authorization tracking, charge entry, claim submission, payment posting, denial management, and patient billing.
• Build and maintain eligibility and benefits verification workflows, including real-time eligibility checks and coordination of benefits (COB) logic.
• Configure prior authorization tracking, workflow routing, and status update logic within the RCM platform and integrated systems.
• Support the configuration of patient statement workflows, payment plan setups, and patient portal integrations for self-pay collections.
• Ensure billing configurations comply with payer-specific rules, CMS guidelines, and applicable regulatory requirements (HIPAA, No Surprises Act, etc.).
• Partner with RCM leadership and billing teams to identify workflow inefficiencies, configure system solutions, and measure performance improvements.
• Design and maintain RCM performance dashboards and reports covering key metrics: clean claim rate, denial rate, days in AR, collection rate, first-pass resolution rate, and payer-specific performance.
• Build and automate reporting outputs for RCM leadership, Finance, and clinical operations using the platform's native reporting tools and connected BI tools such as Power BI.
• Support month-end close activities by providing accurate revenue, collections, and AR aging data; assist Finance with reconciliation between the RCM platform and NetSuite.
• Develop and maintain data dictionaries, field mapping documentation, and data lineage records for all RCM data flows and integrations.
• Assist the Data & Analytics team.
• Lead or co-lead RCM system implementations, module deployments, and integration projects from requirements gathering through go-live and hypercare.
• Develop and maintain project documentation including implementation plans, configuration workbooks, test scripts, cutover checklists, and training materials.
• Coordinate and lead UAT with RCM, clinical, and Finance stakeholders; manage defect tracking, resolution, and sign-off.
• Produce high-quality technical documentation including Business Requirements Documents (BRDs), Functional Specifications, data flow diagrams, and integration design documents.
• Serve as Tier-2/Tier-3 application support for CollaborateMD and connected RCM systems; triage, diagnose, and resolve complex functional and technical issues.
• Troubleshoot integration failures, claim rejection patterns, ERA posting errors, and data discrepancies across connected systems.
• Coordinate with CollaborateMD support, clearinghouse partners, and payer EDI teams to resolve technical issues and implementation blockers.
• Administer user access, role-based permissions, and audit controls in compliance with HIPAA and internal security standards.
• Maintain and enforce data governance standards including PHI handling, data retention policies, and access logging within the RCM platform.
• Create and maintain system documentation, SOPs, troubleshooting guides, and knowledge base articles for RCM platform users and the IT team.

Benefits

• 21 paid days off (15 days of PTO, which increases with tenure, plus 6 holidays).
• Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
• Medical, dental, vision, long-term disability, and life insurance.
• Generous 401(k) with up to 6% employer match.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed