Note: The job is a remote job and is open to candidates in USA. Contemporary Staffing Solutions (CSS) is seeking a Business Analyst Healthcare Revenue Cycle 835 EDI Remittance Focus to support accurate payment processing and operational efficiency across revenue cycle workflows. The role involves analyzing EDI 835 transactions and collaborating with technical and operational teams to enhance payment workflows and data accuracy.
Responsibilities
- Analyze EDI 835 remittance files to interpret payment activity including denials, adjustments, reversals, and coordination of benefits scenarios
- Develop and refine business rules that support accurate claim level and line level payment processing across complex reimbursement scenarios
- Partner with technical and operational stakeholders to define requirements and translate revenue cycle processes into clear functional documentation
- Design prioritization logic, filtering rules, and reconciliation workflows to improve remittance processing and reporting accuracy
- Identify inconsistencies and edge cases within data, support testing efforts, and recommend scalable enhancements to systems and processes
Skills
- Strong experience within healthcare revenue cycle operations with a focus on 835 transactions and remittance processing
- Deep understanding of EDI structures including loops, segments, and payer response formats
- Ability to evaluate complex payment scenarios and translate findings into actionable business and system requirements
- Excellent collaboration and communication skills with the ability to support cross functional teams and system testing initiatives
- Experience working with clearinghouses, payer systems, or revenue cycle platforms is preferred along with familiarity with 837 claims
Benefits
- Flexible remote environment
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