Service Operations Engineer – Revenue Cycle Management (US Healthcare)

Role Summary

The Service Operations Engineer – RCM supports mission‑critical US healthcare Revenue Cycle Management applications, ensuring high availability, performance, and compliance. This role applies ITIL service operations practices to systems that directly impact patient billing, claims, reimbursements, and cash flow. The ideal candidate brings strong hands‑on support experience combined with solid US RCM domain knowledge.

Key Responsibilities

Service Operations & Support

Manage incidents and service requests for RCM applications (billing, claims, payment posting, denial management, reporting).
Meet SLAs while minimizing impact to billing cycles and payer submissions.
Participate in 16/5 and weekend on‑call support for revenue‑critical systems.

Incident & Problem Management

Troubleshoot issues across end‑to‑end RCM workflows (claims, remittance, EDI, batch jobs).
Prioritize incidents based on revenue impact and payer timelines.
Perform root cause analysis and drive permanent fixes for recurring issues.

Monitoring & Maintenance

Monitor RCM applications and interfaces using iTelemetry and related tools.
Configure alerts for revenue‑impacting failures (claim backlogs, interface drops, job failures).
Perform patching and maintenance while protecting billing cut‑offs and month‑end close.

Compliance & Security

Ensure operations comply with HIPAA, PHI, SOX, and US healthcare regulations.
Manage access controls, vendor access, and security configurations for financial and patient data.

Vendor & Stakeholder Collaboration

Coordinate with RCM vendors, clearinghouses, and internal business teams.
Support payer rule changes, regulatory updates, and system upgrades.
Communicate incidents and risks in business‑impact terms.

Documentation & Continuous Improvement

Maintain KBAs and SOPs for RCM operations and recurring issues.
Track SLAs, MTTR, and incident trends; recommend improvements and automation.

Required Skills & Experience

Strong understanding of US Revenue Cycle Management workflows
Experience with claims lifecycle, EDI (837/835), clearinghouses, payer rules, and denial management
Hands‑on experience supporting revenue‑critical healthcare applications
Solid foundation in ITIL Service Operations (Incident, Problem, Change)
Strong troubleshooting, communication, and stakeholder‑management skills

Sr. Service Operations Engineer