Service Operations Engineer Revenue Cycle Management (US Healthcare)
Role Summary
The
Service Operations Engineer RCM supports missioncritical
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 handson 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 oncall support for revenuecritical systems.
Incident & Problem Management
- Troubleshoot issues across endtoend 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 revenueimpacting failures (claim backlogs, interface drops, job failures).
- Perform patching and maintenance while protecting billing cutoffs and monthend 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 businessimpact 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
- Handson experience supporting revenuecritical healthcare applications
- Solid foundation in ITIL Service Operations (Incident, Problem, Change)
- Strong troubleshooting, communication, and stakeholdermanagement skills
