Business Analyst (RCM - Healthcare Technology)

Business AnalystDepartment: Product Management / Software DevelopmentReports To: Product ManagerLocation: On-Site (preferred), Hybrid, or RemoteIndustry: Healthcare Technology, Revenue Cycle Management (RCM)Position SummaryThe Business Analyst serves as the critical link between healthcare operations, revenue cycle management (RCM), and software development teams. This role is responsible for gathering, analyzing, documenting, and validating business requirements related to post-acute care billing workflows, reimbursement processes, claims management, and payer integration solutions.The ideal candidate possesses strong knowledge of reimbursement methodologies, medical billing operations, and healthcare software development practices. They will collaborate with stakeholders across product management, engineering, quality assurance, implementation, and customer success teams to design and deliver solutions that improve billing accuracy, operational efficiency, regulatory compliance, and financial outcomes for healthcare providers.Key ResponsibilitiesBusiness Analysis & Requirements ManagementElicit, analyze, document, and manage business, functional, and technical requirements.Conduct stakeholder interviews, workflow analysis, and discovery sessions with customers and internal teams.Develop detailed user stories, process flows, use cases, business rules, and acceptance criteria.Translate complex healthcare billing requirements into actionable specifications for software development teams.Identify process improvement opportunities and recommend technology solutions.Healthcare Revenue Cycle & Billing ExpertiseAnalyze workflows related to:Claims creation and submissionElectronic remittance processing (ERA)Eligibility verificationDenial managementPayment postingAccounts receivable managementContract and reimbursement managementSupport product enhancements for Medicare, Medicaid, Managed Care, and Commercial Payer billing requirements.Monitor regulatory and payer changes affecting reimbursement and billing operations.Product & Development CollaborationPartner with Product Managers to define product roadmaps and feature requirements.Work with software developers to clarify requirements throughout the development lifecycle.Participate in Agile ceremonies including backlog grooming, sprint planning, reviews, and retrospectives.Assist Quality Assurance teams with test scenarios and validation activities.Review delivered functionality to ensure alignment with business requirements.Data Analysis & ReportingAnalyze billing, claims, and reimbursement data to identify trends and opportunities.Create reports, dashboards, and metrics to support product decisions.Validate data integrity between healthcare systems and integrated applications.Support root cause analysis for production issues and customer-reported defects.Customer & Stakeholder EngagementServe as a subject matter expert for post-acute care billing workflows.Collaborate with customers to understand operational challenges and product enhancement opportunities.Support product demonstrations, customer meetings, and implementation discussions.Assist training and documentation teams with user-focused materials.Required QualificationsEducationBachelor's degree in Business Administration, Healthcare Administration, Information Systems, Computer Science, Finance, or a related field.Equivalent healthcare technology experience may be considered in lieu of degree requirements.Experience3+ years of Business Analyst experience in healthcare software, healthcare IT, or revenue cycle management.2+ years of experience supporting medical billing, claims management, or healthcare reimbursement operations.Experience working in Agile software development environments.Proven experience documenting requirements and translating business needs into software solutions.Technical SkillsRequirements gathering and documentationProcess mapping and workflow analysisUser story creation and backlog managementSQL and data analysis preferredREST APIs and healthcare system integrations preferredMicrosoft Office Suite, Azure DevOps, Jira, Confluence, or similar toolsHealthcare KnowledgeUnderstanding of:Medical billing and collectionsMedicare and Medicaid reimbursement methodologiesUS healthcare, including CMS regulations and compliance requirementsElectronic claims and remittance standardsPayor requirementsPreferred QualificationsExperience with RCM platforms, clearinghouses, EHR/EMR systems, or practice management software.Knowledge of healthcare interoperability standards such as HL7, FHIR, X12, and EDI transactions.Familiarity with Value-Based Care and alternative payment models.Core CompetenciesBusiness Process AnalysisRevenue Cycle Management ExpertiseHealthcare Domain KnowledgeRequirements DocumentationProblem Solving and Critical ThinkingStakeholder ManagementCommunication and Presentation SkillsAgile MethodologiesData-Driven Decision MakingCross-Functional CollaborationSuccess MetricsThe Business Analyst will be evaluated on:Requirements quality and completenessProduct delivery success ratesReduction in billing and claims processing issuesStakeholder satisfactionDevelopment team efficiencyProduct adoption and customer feedbackRevenue cycle performance improvementsRegulatory and compliance adherenceThis role directly contributes to the development of innovative billing solutions that optimize reimbursement, improve operational efficiency, and help healthcare organizations deliver exceptional patient care while maximizing financial performance.