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Lead Billing Strategy & Systems Analyst (Remote)

Claims TheoryAustin, TX
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Job Description

The Billing Strategy & Systems Analyst at will play a critical role in driving strategic initiatives and day-to-day operational insights across Revenue Cycle Management (RCM). As a seasoned subject matter expert (SME) in healthcare billing, payer eligibility, and reimbursement, this individual will serve as a bridge between data, process, and leadership—translating operational needs into intelligent billing strategies and scalable solutions. 

You will be deeply involved in data analytics, claims auditing, billing system configurations, and delivering data insights and reports. You'll help optimize workflows, introduce new technologies, improve data pipelines, and lead configuration efforts for systems such as AdvancedMD, Salesforce, and EMRs. This role is ideal for a dynamic, self-directed expert who thrives in a fast-paced, data-driven environment and enjoys solving tough problems that impact the full claims lifecycle. 

Key Responsibilities: 

Data Analytics & Reporting 

  • Write advanced SQL queries and work within Snowflake to pull, analyze, and interpret data from multiple sources for ad hoc and recurring requests. 
  • Conduct complex data analyses across claim volumes to identify trends, pain points, and improvement opportunities. 
  • Create custom dashboards and automated reporting in Power BI and Excel to provide live insights to stakeholders. 
  • Develop and deliver executive-level presentation decks to communicate findings, operational KPIs, and recommendations to leadership. 

Workflow Auditing & Operational Strategy 

  • Perform audits in systems like AdvancedMD and Salesforce to connect SOPs and workflows to real-world data behavior. 
  • Identify workflow gaps and recommend improvements based on system configurations, audit results, and reimbursement outcomes. 
  • Act as a strategic partner to leadership by “telling the story” through data — bridging operations and data insights to guide decision-making. 

Revenue Cycle Subject Matter Expertise 

  • Serve as the internal SME on RCM processes, particularly around eligibility, pre-registration, pre-access, payer policy, and reimbursement requirements
  • Ensure billing workflows are set up to yield clean claims on the front end and maximize reimbursement on the back end. 
  • Interpret payer contracts, manage denial trends, and develop strategies to increase collection efficiency and reduce rework. 

System Optimization & Technology Implementation 

  • Lead billing system configuration efforts and support the setup of new processes and workflows within various systems, tools and portals. 
  • Vet and implement new vendors and tools (e.g., claim scrubbing, FrontRunnerHC) to support automated claim processes and data quality. 
  • Conduct QA and QC reviews of configuration changes, claim logic, and EMR setups to ensure billing accuracy. 
  • Assist with the implementation and optimization of EDI processes (e.g., 271 eligibility responses). 

Required Qualifications: 

  • Bachelor's degree in Business, Health Informatics, Data Science, or related field (Master's preferred). 
  • Minimum 8 years of experience in healthcare billing, RCM operations, or payer strategy—ideally with lab billing experience. 
  • Expert-level knowledge of SQL, Snowflake, Excel, and Power BI (including dashboard development). 
  • Proven ability to create clean, compelling presentations and data visualizations for executive audiences. 
  • Ideally will have hands-on experience with AdvancedMD, Salesforce, EMRs, and payer portals. 
  • Strong understanding of eligibility workflows, pre-access, payer policy, denial management, and claims adjudication
  • Experience with billing system configuration, vendor vetting, and automating claims processes
  • Familiarity with FrontRunnerHC, EDI automation, and healthcare tech integration best practices. 

Preferred Attributes: 

  • Strong analytical, organizational, and communication skills. 
  • Curious, tech-savvy, and driven to constantly improve systems and workflows. 
  • Comfortable with fast-paced environments and high-impact executive deliverables. 
  • Collaborative mindset, able to influence cross-functional teams and lead from both a strategic and tactical level. 

  

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations. 

Austin, TX 

$100,000 - $130,000 USD