Under the managerial oversight of the Director, the Revenue Integrity Analyst serves as a primary point of contact for service line directors, managers, finance directors, clinical support staff, physicians, allied health care providers, hospital colleagues, and others regarding professional and hospital revenue charge capture, revenue cycle, and modality-specific billing workflows.
The role focuses on educating providers and clinical colleagues on accurate professional and facility billing and revenue capture while adhering to CMS and third-party payer regulations. It also supports the implementation of new revenue capture procedures in the hospital chargemaster, workflow development, internal audits, reporting, and process improvements aimed at maximizing accurate revenue capture and reimbursement.
Minimum Qualifications
- Associate degree required; in the absence of an associate degree, an additional 4 years of healthcare revenue cycle experience beyond the required 2 years is required.
- Epic proficiency or certification in Charge Description Master (CDM).
- Minimum 2 years of healthcare revenue cycle experience.
Skills and Knowledge
- Working knowledge of medical and hospital billing practices, billing software, health insurance, and CMS regulations.
- Knowledge of CPT, HCPCS, and ICD-10 coding principles.
- Knowledge of Epic or related hospital ADT/billing software.
- Proficiency with data entry and electronic systems.
- Ability to read, analyze, and interpret financial reports.
- Strong problem-solving, analytical, and communication skills.
- Excellent organizational skills, attention to detail, and multitasking ability.
- Proficiency with Excel.
Location
Boston, Massachusetts, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago