RCMS Configuration Specialist I

Qualifacts; Tampa (FL); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Qualifacts is seeking a RCMS Configuration Specialist I to support onboarding, revenue cycle implementation, and EDI/RCMS configuration across healthcare solutions. You will guide customers from kickoff to go-live, assess billing workflows, and ensure successful adoption of RCMS processes.

The role requires healthcare billing experience, EHR configuration savvy, and strong customer-facing skills, with up to 25% travel. Hybrid schedule in Nashville or Tampa.

Qualifications

• Bachelor’s degree or equivalent experience in healthcare IT or medical billing.
• Healthcare billing experience required; behavioral health billing preferred.
• Knowledge of CMS UB-04 institutional billing formats.
• Experience with EDI, payer enrollment, and RCM workflows.
• SaaS or cloud implementations and EHR configuration experience preferred.
• CPB certification a plus.

Responsibilities

• Lead and support new customer RCM implementations from kickoff through go-live.
• Assess billing workflows and recommend configuration aligned with best practices.
• Configure systems for accurate billing, claims submission, and reimbursement workflows.
• Set up and maintain EDI clearinghouse configuration for multiple clients.
• Conduct billing analysis, configuration reviews, and customer training.
• Document and track billing requirements to support compliance and accountability.
• Resolve inquiries and issues, including denials and workflow concerns.

Skills

Revenue cycle management

EHR configuration

Customer onboarding

Project management

Payer requirements

Cloud/SaaS implementations

Detail-oriented

Education

Bachelor’s degree or equivalent in healthcare IT/billing

Tools

EDI Clearinghouse

EHR/EMR tooling

Qualifacts platform

Job description

Job Description

We are seeking candidates in Nashville or Tampa to work a hybrid schedule in either office location. Remote candidates will not be considered.

RCMS Configuration Specialist I

Summary Of The RCMS Configuration Specialist I

We are seeking an RCMS Configuration Specialist to support new customer onboarding, revenue cycle implementation, billing configuration, and EDI clearinghouse setup across healthcare technology solutions. This role combines institutional and professional billing expertise, revenue cycle knowledge, EHR configuration experience, and strong customer-facing communication skills. The specialist will guide customers through implementation from kickoff through go-live, assess billing workflows, configure RCM-related functionality, support training, document requirements, and ensure customers are prepared for successful adoption of billing and RCMS processes.

Responsibilities For The RCMS Configuration Specialist I

• Lead and support new customer RCM implementations from kickoff through go-live, ensuring a smooth, organized, and efficient onboarding experience.
• Assess customer billing workflows, including insurance, self-pay, institutional billing, and reporting requirements, and recommend configuration solutions aligned with best practices.
• Interpret how customers are credentialed with payers and apply that knowledge to configure systems for accurate billing, claims submission, and reimbursement workflows.
• Set up and maintain EDI clearinghouse configuration for multiple EHR and RCMS services customers.
• Conduct billing analysis, configuration review, workflow sessions, and customer training to support implementation readiness and adoption.
• Advise on, present, and support RCM-related EHR configurations, including claim setup, payer requirements, billing workflows, and reporting needs.
• Review and validate software billing configurations with customer implementation teams to ensure quality, accuracy, and readiness for end-user training.
• Document and track customer billing, configuration, EDI, and reporting requirements to support compliance and implementation accountability.
• Resolve client inquiries and configuration issues promptly while maintaining ownership through resolution, including billing denials, rejections, and workflow concerns.
• Maintain project documentation and provide clear communication through agendas, meeting minutes, CRM updates, and project management tools.
• Co-facilitate multiple RCM implementation projects concurrently and collaborate with internal teams on configuration updates and issue resolution.
• Build and maintain positive, productive relationships with customers and internal stakeholders while supporting a consultative implementation approach.
• Execute Payer Testing for all RCMS Payers prior to Go Live, addressing any required configuration adjustments in order to successfully complete Payer Testing.
• Identify and Track Billing Guidelines and Payer Requirements to inform RCMS Stakeholders for ongoing support.

Qualifications Of The RCMS Configuration Specialist I

• Bachelor’s degree or equivalent experience using EHR applications for medical billing, behavioral healthcare billing, or revenue cycle operations required.
• Healthcare billing experience required; behavioral health billing experience preferred.
• Knowledge of standard CMS Billing Requirements and Formats required
• Knowledge of UB-04 institutional billing requirements required; experience with residential, hospital, ASC, or similar billing environments preferred.
• Basic understanding of clearinghouse EDI relationships, payer enrollment, claims submission, and RCM workflows.
• SaaS or cloud implementation experience preferred; EHR/EMR implementation or configuration experience strongly preferred.
• Basic understanding of at least one Qualifacts software platform preferred.
• CPB (Certified Professional Biller) certification a plus

Knowledge, Skills, and Abilities of the RCMS Configuration Specialist I

• Comprehensive understanding of revenue cycle management systems, billing workflows, payer requirements, and EHR configuration principles.
• Ability to synthesize billing, configuration, and workflow requirements into practical implementation plans and customer-ready solutions.
• Strong knowledge of RCM-related system configurations, clearinghouse integrations, claims workflows, denials, rejections, and reporting needs.
• Exceptional customer service, facilitation, and written and verbal communication skills.
• Strong organization, time management, follow-through, and ability to manage multiple implementation priorities concurrently.
• Ability to project manage, coordinate tasks, collaborate across teams, and support delegated configuration activities.
• Strong analytical and problem-solving skills with attention to detail and the ability to recommend alternative approaches when needed.
• Familiarity with CCBHC, HIPAA, and state-specific billing requirements preferred.
• Ability to collaborate effectively in a remote environment and build trusted relationships with customers and internal stakeholders.
• Willingness to travel up to 25% as needed.

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