Revenue Cycle Solutions Analyst - Payer

HHAeXchange is the leading technology platform for home and community-based care. Founded in 2008, HHAeXchange was born out of an idea to create a fully comprehensive end-to-end homecare solution to help people who are aging or have disabilities thrive in their homes and communities. Our employees are passionate about transforming the healthcare space by building the only homecare ecosystem that fully connects patients, personal care providers, managed care organizations, and states.  

As a Revenue Cycle Solutions Analyst, you will focus on the implementation, ongoing maintenance, and optimization of home care-focused revenue cycle solutions, with an emphasis on payer integrations and billing configuration. You will support payer onboarding and implementation activities by researching and analyzing payer business and technical requirements, reviewing payer specifications and companion guides, and translating requirements into scalable system configurations. Responsibilities include configuring and maintaining payer-specific billing rules, claim submission requirements, enrollment requirements, reimbursement workflows, and system integrations; researching and troubleshooting issues; and identifying and implementing best-fit solutions. You will execute configuration changes, testing, validation, documentation, and refinement to enable accurate and seamless data exchange between providers, payers, HHAeXchange, and partner organizations. The role requires collaboration across implementation, product, engineering, operations, and client-facing teams and provides an opportunity to deepen expertise in Medicaid/MCO revenue cycle processes, healthcare claims workflows, healthcare data standards (X12, HL7, FHIR), EDI transactions, and systems integration.

To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily with or without reasonable accommodation. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position is open to candidates located within the New York City, Minneapolis, and Miami metro areas only.

Essential Job Duties

Partner with Business Analysts and cross-functional teams to gather, analyze, validate, and document customer, payer, business, and technical requirements for new implementations and ongoing revenue cycle integrations and configurations.
Manage payer integration and configuration delivery efforts from requirements gathering through testing and production readiness to ensure high-quality delivery of home care revenue cycle solutions.
Analyze payer specifications, companion guides, business requirements, and implementation documentation and translate requirements into scalable system configurations and integration solutions.
Configure and maintain payer-specific billing requirements, including billing rules, claim submission logic and requirements, enrollment requirements, reimbursement workflows, and related system configurations.
Analyze and troubleshoot reported integration, configuration, enrollment, and claim submission issues; perform root cause analysis; and propose and implement corrective actions.
Partner with Implementation, Product, Engineering, Operations, and client-facing teams to identify workflow gaps, resolve cross-functional dependencies, and support successful payer onboarding and implementation.
Assist Senior Solution Analysts with complex business and technical requirements to identify and implement best-fit solutions.
Execute testing, validation, and quality assurance of new and existing configurations and integrations to ensure accuracy, alignment with customer and payer requirements, and applicable compliance standards.
Support payer onboarding, implementation, production readiness, enhancement requests, and ongoing optimization of existing payer integrations and billing configurations.
Monitor and maintain existing configurations and integrations to support continued performance, accuracy, and compliance, and identify opportunities for optimization and continuous improvement.
Contribute to the development and enhancement of internal documentation, tools, process standards, training materials, and best practices to support consistent and scalable solution delivery.
Create and maintain required documentation for new and existing integrations and configurations, including documented requirements, configuration decisions, testing outcomes, and operational processes.
Facilitate knowledge transfer and develop supporting documentation to enable smooth transition to post-implementation and production support teams.
Serve as a knowledgeable resource during payer onboarding and integration discussions by helping bridge technical, operational, payer, and customer requirements.
Adhere to established SLAs and delivery standards while maintaining solution quality, minimizing rework, and supporting timely resolution of issues.

Other Job Duties

• Other duties as assigned by supervisor or HHAeXchange leader

Travel Requirements

• Travel up to 10%, including overnight travel

Required Education, Experience, Certifications and Skills

4+ years of experience in healthcare solution delivery, revenue cycle configuration, healthcare data integration, claims processing, payer operations, healthcare technology, or healthcare software implementation.
Experience gathering, analyzing, validating, and documenting business and technical requirements and translating requirements into configuration or integration solutions.
Experience working within configuration-driven software platforms and managing multiple implementation, configuration, or integration activities simultaneously while delivering quality solutions that meet customer expectations.
Experience troubleshooting complex issues and performing data and root cause analysis to identify risks, configuration gaps, and corrective actions.
Familiarity with home care operations, Medicaid/MCO billing, healthcare claims workflows, payer requirements, and revenue cycle processes.
Knowledge of healthcare data standards and EDI transactions, including X12 and transactions such as 837, 835, 270/271, and 276/277; familiarity with HL7 and FHIR.
Knowledge of healthcare integration methods and protocols, including sFTP and API.
Ability to review and interpret payer specifications, companion guides, implementation requirements, and other technical or operational documentation.
Ability to learn quickly, prioritize effectively, manage multiple responsibilities, and collaborate across Implementation, Product, Engineering, Operations, and client-facing teams.
Strong attention to detail, analytical thinking, problem-solving, and organizational skills.
Proven written and verbal communication skills, including the ability to clearly communicate technical and operational information to varied audiences.
Ability to lead and influence discussions, respectfully challenge assumptions, ask effective discovery questions, and support decisions based on validated requirements and documented information.
Experience with ticket, project, and content management applications such as JIRA, Salesforce, Confluence, and SharePoint.
Exposure to State Medicaid Agencies, Managed Care Organizations (MCOs), home care providers, clearinghouses, or other healthcare payer organizations is a plus.
Healthcare SaaS environment experience is a plus.