Systems Analyst - CMS Encounter Implementation

The Systems Analyst - CMS Encounter Implementation supports the end-to-end implementation of CMS encounter submissions for new and expanding payer clients. This role leads requirements gathering, data mapping, testing coordination, and go-live readiness activities to ensure encounter submissions meet CMS regulatory and validation requirements.

The analyst works closely with project management, engineering, data, and client teams throughout the implementation lifecycle, from discovery through production readiness.

Key responsibilities include:

• Leading requirements gathering sessions with internal and client stakeholders
• Documenting business and technical requirements for encounter implementations
• Defining encounter submission specifications aligned to CMS guidelines and client configurations
• Performing gap analysis between source system data and CMS encounter requirements
• Developing and maintaining data mappings for CMS-compliant encounter files such as 837P and 837I
• Supporting unit, integration, and user acceptance testing
• Validating test files and analyzing CMS response files including 999, 277CA, and MAO feedback
• Writing and executing SQL queries to analyze source data and reconcile test results
• Partnering with engineering and data teams to troubleshoot data transformation and processing issues
• Supporting go-live readiness, handoff to operations or BPO teams, and long-term implementation documentation
• Serving as an implementation subject matter expert for CMS encounter submissions