Claim Configuration Analyst Jobs in Austin, TX (NOW HIRING)

Description

Job Purpose

The Revenue Cycle Systems Lead serves as the internal owner of the organization's revenue cycle systems infrastructure, with primary responsibility for athenahealth and operational oversight of workflows supported by Adonis. This position acts as the bridge between Revenue Cycle Operations, IT, Finance, leadership, athenahealth, and Adonis to ensure front-end and back-end revenue cycle workflows are configured appropriately, operating effectively, and continuously improving.

The ideal candidate combines deep athenaHealth platform expertise with strong revenue cycle knowledge and the ability to translate business problems into system configuration, reporting, workflow design, and vendor action. This role oversees system integrity, reporting accuracy, work queue logic, and operational workflows while serving as the primary internal partner to Adonis for optimization of APC's revenue cycle infrastructure.

Primary Duties Include, But Are Not Limited to the Following

Platform Ownership: athenaHealth and Adonis

• Serve as the primary internal owner of RCM athena configuration, administration, and day-to-day optimization.
• Act as the main operational point of contact for Adonis, partnering on workflow design, issue triage, reporting needs, data validation, and ongoing performance improvement.
• Ensure athenaHealth and Adonis are aligned to current-state operational workflows, escalation paths, work queues, and reporting requirements.
• Partner with operational leaders to identify breakdowns in process, system logic, or data quality and translate them into corrective actions.
• Maintains a strong understanding of where work should occur in athenaHealth versus Adonis and helps the organization use both platforms effectively.

athenaHealth System Administration and Configuration

• Manage athenaOne and athenaNet configuration for billing-related settings, and system maintenance.
• Maintain key table structures and configuration elements that support accurate charge capture, claim management, remittance posting, and operational reporting.
• Monitor platform health and proactively identify system, interface, or configuration issues that could affect revenue cycle performance.
• Oversee relationships and case management with athenahealth support and the athena CSM, including escalation tracking, issue documentation, follow-up, and resolution.
• Has regular and predictable attendance.
• Adheres to Advanced Pain Care policies and procedures.
• Performs other duties as assigned.

Revenue Cycle Workflow Oversight

• Oversee core revenue cycle workflows supported by the system infrastructure, including claim edits, denials, follow-up work queues, remittance-related issues, and productivity workflows.
• Review and optimize athenaNet rules engine logic and automated billing workflows to reduce preventable rejections and improve staff efficiency.
• Partner with Revenue Cycle leaders to ensure system workflows reflect operational priorities and support accountability across teams.
• Help define, document, and improve standard operating procedures tied to system-supported revenue cycle work.

Reporting, Data Integrity, and Analytics

• Own the integrity and reliability of revenue cycle reporting sourced from athenahealth and supported by Adonis outputs.
• Build, maintain, and distribute recurring reporting packages such as A/R aging, collections, denial trends, productivity, and other operational KPI dashboards.
• Support ad hoc reporting and benchmark analysis for leadership, finance, and operations and RCM teams using athenaHealth reporting tools and other business intelligence tools as needed.
• Validate data consistency across athenahealth, Adonis, and internal reporting to ensure stakeholders are working from trusted information.
• Identify reporting gaps and partner with Adonis and internal stakeholders to improve visibility into operational and financial performance.

Vendor Partnership and Continuous Improvement

• Serve as a day-to-day partner to Adonis on configuration questions, workflow tuning, implementation of enhancements, issue resolution, and value realization.
• Support testing, user acceptance, rollout readiness, and change management for new workflows or reporting enhancements.
• Track recurring issues, root causes, and improvement opportunities across athenahealth and Adonis and drive them to closure.
• Help leadership assess whether current system usage, workflows, and vendor capabilities are supporting target revenue cycle outcomes.

Other Job Requirements

• Presents a professional image and customer-focused approach.
• Practices teamwork by helping others willingly and communicating in a professional manner.
• Updates job knowledge by participating in educational opportunities, reviewing payer updates, and staying current on revenue cycle technology trends.
• Serves and protects the practice by adhering to professional standards, policies and procedures, and federal, state, and local requirements.
• Enhances practice reputation by accepting ownership for accomplishing new and different requests and identifying opportunities to add value to job performance.
• Operates standard office equipment, including computer, copier, scanner, telephone, and related office technology.

Requirements

Supervision

Reports to the Revenue Cycle Director with dotted line to the Analytical team

Minimum Qualifications

Education: High school diploma or GED required. Bachelor's degree in healthcare administration, health information management, information systems, business, finance, or a related field is preferred.

Experience: Minimum 4 years of experience in athenahealth administration, healthcare IT, revenue cycle systems, revenue cycle operations, or a closely related role. Hands-on experience configuring and maintaining athenaOne, athenaNet, athenahealth reporting tools, and Custom Report Builder is strongly preferred.

Working Conditions

Environmental Conditions: Medical office and administrative office environment.

Physical Conditions: Must be able to work as scheduled, typically during standard business hours. Must be able to sit and/or stand for prolonged periods of time; bend, stoop, and stretch as needed; lift and move items weighing up to 30 pounds; and use eye-hand coordination and manual dexterity sufficient to operate office equipment.

Knowledge, Skills and Abilities

• Clear and precise communication with Revenue Cycle Operations, IT, Finance, executive leadership, athenahealth, Adonis, and other external vendors.
• Strong working knowledge of revenue cycle operations, including claims, denials, remittance, reimbursement workflows, A/R management, and operational KPI reporting.
• Hands-on knowledge of athenahealth configuration, athenaNet rules engine logic, work queues, reporting tools, and system administration.
• Ability to validate data consistency across athenahealth, Adonis, and internal reporting sources.
• Strong analytical skills, including proficiency in Excel; experience with SQL, Power BI, or similar reporting tools is preferred.
• Familiarity with EDI transactions, remittance workflows, clearinghouse processes, and healthcare data interfaces such as HL7 is preferred.
• Working knowledge of CPT, ICD-10, payer workflows, and common denial or adjustment patterns.
• Ability to manage priorities, organize work effectively, identify process gaps, and drive issues to resolution with clear ownership.
• Protects patient information and maintains confidentiality.