RCM Workflow Analyst at CLS Health PLLC

Webster, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Jan, 26

Salary

0.0

Posted On

15 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Revenue Cycle Management, Claim Lifecycle, Denial Management, Standard Operating Procedures, Workflow Mapping, Automation Tools, Analytical Skills, Problem-Solving Skills, Compliance Requirements, Healthcare Reimbursement Models, Microsoft Office Suite, Coding, Billing, Audits, Appeals, Healthcare Operations

Industry

Hospitals and Health Care

Description

Description About CLS Health: At CLS Health, we are redefining healthcare delivery. As Houston’s largest physician-owned, physician-led healthcare system, our mission is to provide patient-centered care through innovation and operational excellence. With over 200 providers in 35+ locations and over 50 specialties, we’re building a scalable healthcare system that empowers physicians and delivers unmatched quality and access for patients. We are Looking for: We are seeking a detail-oriented and process-driven RCM Workflow Analyst to help map, optimize, and standardize the end-to-end revenue cycle process from patient encounter to claim resolution. The ideal candidate has strong experience in revenue cycle operations, a deep understanding of the claim lifecycle, and familiarity with denial management tools. You’ll play a key role in developing scalable SOPs, supporting exception handling logic, and partnering with stakeholders to ensure that automation opportunities are effectively implemented. Key Responsibilities: Map and document the full claim lifecycle, from patient encounter through coding, billing, edits, denials, appeals, and resolution. Identify process inefficiencies and recommend automation opportunities, including rule-based logic for exceptions, holds, and audits. Develop and maintain standard operating procedures (SOPs) for: Claim holds and edits Coding and billing audits Appeal types and workflows Collaborate with RCM, compliance, product, and engineering teams to align business workflows with system capabilities. Support development and implementation of automation tools and decision trees (e.g., Coder+ workflow engine). Analyze trends in denials and exceptions to guide continuous process improvement. Assist in UAT and workflow validation during system changes or product deployments. Why You’ll Love Working With Us: Competitive salary Supportive team culture Real opportunities for professional development and career growth Full benefits package including: 401(k) with company match Medical, Dental, Vision, and Life Insurance Paid time off Disability insurance Requirements 3–5 years of experience in Revenue Cycle Management or healthcare operations, preferably in a multi-specialty or large provider setting. Strong knowledge of the claim lifecycle, including coding, billing, edits, denials, and appeals. Experience using or managing denial management tools or RCM platforms (e.g., Epic, athenahealth, eClinicalWorks). Proven ability to document workflows and develop SOPs for operational teams. Strong analytical and problem-solving skills; ability to work with both technical and non-technical stakeholders. Familiarity with compliance requirements, payer policies, and healthcare reimbursement models. Proficient in Microsoft Office Suite, especially Visio or Lucidchart for workflow mapping. Preferred Qualifications: Experience with coding and billing automation or workflow tools. Exposure to healthcare analytics or RCM reporting dashboards. Bachelor’s degree in Health Information Management, Business, Healthcare Administration, or a related field.

Responsibilities

The RCM Workflow Analyst will map and document the full claim lifecycle, identify process inefficiencies, and recommend automation opportunities. They will also develop and maintain standard operating procedures and collaborate with various teams to align business workflows with system capabilities.