Revenue Integrity Specialist- Remote

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.

Key Responsibilities

• 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

Minimum Qualifications

• 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

Education

• High School Diploma or GED required
• Bachelor’s Degree preferred

Experience

• Minimum of 1 year of experience in a hospital or healthcare billing environment required
• Experience with revenue cycle, charge capture, denial management, or coding preferred

Schedule
Full time- remote

Boston Children’s Hospital Benefits
Boston Children’s Hospital offers competitive compensation and unmatched benefits including 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, cell phone plan discounts, and discounted T-passes. Experience the benefits of passion and teamwork.

Full-Time

Regular

40

$58676.80-$93901.60 Annual

Boston

Administration

Full-Time Remote