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The Revenue Integrity Specialist supports Boston Children’s Hospital’s surgical and clinical practices by helping ensure accurate billing, appropriate charge capture, and strong compliance across the revenue cycle. This role focuses on identifying revenue opportunities, reducing denials, and minimizing financial and regulatory risk. The specialist works closely with clinical departments and the Revenue Integrity team to interpret billing rules, analyze data, and implement process improvements that strengthen revenue performance and compliance.
Job Responsibility
Analyze Epic revenue cycle and usage reports to identify billing errors, trends, and revenue opportunities
Monitor and resolve work queue issues, correcting charge errors and ensuring timely resolution
Review clinical department billing, coding, and charging workflows to ensure accurate revenue capture and compliance with payer and government regulations
Analyze denial data to identify root causes and implement corrective action plans
Provide education, guidance, and training to clinical departments on charge capture, coding, and billing best practices
Support interpretation and implementation of billing and coding rule changes (government and payer updates)
Develop and execute work plans to improve revenue cycle performance and reduce avoidable denials
Partner with Revenue Integrity team members to use reporting tools and dashboards to monitor compliance and financial risk
Assist in maintaining consistent charge capture practices and supporting ongoing compliance efforts across departments
Requirements
Strong understanding of healthcare revenue cycle operations
Ability to analyze billing, coding, and reimbursement data
Experience working with managed care contracts and payer rules
Knowledge of Medicare, Medicaid, and third-party billing guidelines
Ability to identify root causes of billing errors and implement solutions
Strong analytical, problem-solving, and critical thinking skills
Ability to work collaboratively with clinical, financial, and operational teams
Excellent written and verbal communication skills
Minimum of 1 year of experience in a hospital or healthcare billing environment required
Nice to have
Bachelor’s Degree preferred
Experience with revenue cycle, charge capture, denial management, or coding preferred
What we offer
flexible schedules
affordable health, vision and dental insurance
child care and student loan subsidies
generous levels of time off
403(b) Retirement Savings Plan
Pension
tuition and certain license and certification reimbursement