Revenue Cycle Management - AI - Integration BA

Job Description:

Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients.  Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.

• This is an onsite position, 5 days/week, in the Vadodara office

• Shift: - Hours are 6:30pm-3:30am IST. NIGHT/US Shift

• Remote applicants will not be considered.

Position Summary

The Business Analyst – Revenue Cycle Management (RCM) supports the RCM Services department through business and systems analysis, with a primary focus on the VisiQuate and Salesforce platforms. This position collaborates with RCM operations, Finance, Compliance and IT teams to convert business needs into clear functional requirements and system solutions that enhance revenue performance, boost operational efficiency, and support regulatory compliance.

Duties and Responsibilities

• Independently conduct business and systems analysis for Revenue Cycle Management initiatives, including analytics, workflow optimization, and performance improvement efforts.

• Lead discovery and requirements-gathering sessions with RCM stakeholders across Operations, Finance, Compliance, and Revenue Integrity.

• Translate RCM business needs into clear functional requirements, user stories, acceptance criteria, and supporting documentation for enhancements and configuration in Salesforce and VisiQuate.

• Collaborate with business and IT teams to document RCM workflows, data mappings, dashboards, reports, and key performance indicators (KPIs).

• Support Product Managers and Product Owners with backlog refinement, prioritization, and sprint planning activities.

• Analyze and reconcile data from multiple source systems including EHRs, billing systems, claims data, payer data, and workflow tool outputs.

• Partner with stakeholders to ensure RCM solutions align with strategic objectives such as improved collections, reduced denials, and regulatory compliance.

• Participate in all Scrum ceremonies

• Participate in internal and user acceptance testing (UAT), test case development, and validation of analytics and reporting outputs.

• Provide post-release support by collaborating with internal teams and vendors to troubleshoot functional and data-related issues.

• Ensure system functionality is documented, tested, validated, and supported with appropriate end-user training materials.

• Serve as a liaison between RCM business teams and technical delivery teams, fostering collaboration throughout the delivery lifecycle.

Required Experience and Qualifications

• Bachelor’s degree in Business Administration, Information Systems, Healthcare Administration, Finance, or a related field.

• 2+ years of experience as a Business Analyst working with business stakeholders and technical teams.

• Experience defining and documenting business and functional requirements for enterprise applications or analytics platforms.

• Working knowledge of Revenue Cycle Management concepts such as charge capture, coding workflows, denials management, and revenue analytics.

• Experience eliciting requirements through stakeholder interviews, workshops, and process walkthroughs.

• Strong analytical, written, and verbal communication skills.

• Demonstrated ability to work effectively across business and technical boundaries.

• Experience working in Agile or Scrum-based delivery environments.

• Must be fluent in English, both written and verbal.

Preferred Qualifications

• Experience supporting Visiquate or similar Revenue Cycle Management workflow platforms.

• Familiarity with healthcare data sources including EHR, billing, claims, and payer systems.

• Experience with Salesforce, specifically Service Cloud, or other integrated service management platforms.

• Knowledge of healthcare regulatory requirements impacting revenue cycle operations.

Core Competencies

• Strong stakeholder engagement and facilitation skills.

• Data-driven and detail-oriented mindset.

• Ability to manage multiple priorities in a fast-paced environment.

• Collaborative, team-oriented approach with strong interpersonal skills.

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.