Payer Integration & Billing Solutions Analyst — Hybrid

HHAeXchange; Minnesota; On-site; USD 70,000 - 80,000; Full time

Benefits offered by this job

Health plans

Paid time-off

Company 401K with match

Holidays

Job summary

HHAeXchange is seeking a Payer Integration Solutions Analyst to implement and optimize home care revenue cycle integrations with a focus on payer configurations. You will own payer integration work end-to-end, translate payer requirements into scalable configurations, and collaborate across Implementation, Product, Engineering, and Operations to ensure accurate data exchange.

Responsibilities include testing, production readiness, onboarding support, and ongoing optimization of payer

Qualifications

• Four or more years of relevant experience in healthcare revenue cycle, payer operations, claims processing, healthcare technology, healthcare data integration, or healthcare software implementation.
• Working knowledge of Medicaid and managed care organization revenue cycle and payer processes, including claim submission, payer responses, reimbursement, rejections, and denials.
• Working knowledge of healthcare electronic data interchange and X12 standards, including 837, 835, 270/271, and 276/277 transactions.
• Experience interpreting payer specifications, companion guides, implementation requirements, and data elements; documenting business and technical requirements; and translating them into configuration or integration requirements.
• Experience working with configuration-driven software platforms and managing multiple implementation or configuration activities through completion.
• Strong analytical and troubleshooting skills, including the ability to identify root causes, evaluate alternatives, and determine appropriate next steps.
• Knowledge of common healthcare integration methods and technologies, including secure file transfer protocol and application programming interfaces.
• Strong written and verbal communication, organization, attention to detail, and the ability to ask effective discovery questions, challenge assumptions constructively, make recommendations, prioritize work, and collaborate across functions.

Responsibilities

• Gather, analyze, validate, and document customer, payer, business, and technical requirements, and translate payer specifications and companion guides into scalable configurations and integration solutions.
• Independently own assigned payer integration and configuration work from requirements definition through testing, validation, and production readiness.
• Configure and maintain payer-specific billing rules, claim submission logic, enrollment requirements, reimbursement workflows, and related system integrations.
• Analyze and troubleshoot implementation and production issues; identify root causes; evaluate alternatives; and recommend and implement appropriate corrective actions within the role's scope.
• Partner with Implementation, Product, Engineering, Operations, payer, and client-facing teams, and support Senior Solution Analysts on complex requirements, escalations, and broader implementation efforts.
• Execute testing, validation, and quality assurance activities to confirm configurations and integrations meet documented requirements and expected outcomes.
• Support payer onboarding, production-readiness activities, enhancement requests, and ongoing optimization of payer configurations and integrations.
• Monitor and maintain payer configurations and integrations to support performance, accuracy, and compliance with payer requirements.
• Create and maintain requirements, configuration decisions, test results, operating procedures, internal tools, training materials, and best-practice documentation, and provide knowledge transfer.
• Serve as a resource who bridges technical, operational, payer, and customer requirements while meeting service-level agreements, delivery standards, and internal procedures.

Skills

Healthcare revenue cycle

Payer operations

Analytical & troubleshooting

Written and verbal communication

Cross-functional collaboration

Tools

Jira

Salesforce

Confluence

SharePoint

Job description

HHAeXchange is seeking a Payer Integration Solutions Analyst to implement and optimize home care revenue cycle integrations with a focus on payer configurations. You will own payer integration work end-to-end, translate payer requirements into scalable configurations, and collaborate across Implementation, Product, Engineering, and Operations to ensure accurate data exchange.

Responsibilities include testing, production readiness, onboarding support, and ongoing optimization of payer