POSITION SUMMARY:

Under the general direction of the Manager of Revenue Integrity, the Senior Coding and Revenue Integrity Analyst exists to ensure compliant charge capture and revenue tracking for both Boston Medical Center (BMC) and the professional Boston University Medical Group (BUMG) revenue. Operating under limited supervision and working independently, this role monitors regulatory changes, payer requirements, and revenue integrity policies to support compliant coding and billing practices across the enterprise. The position functions as a critical analytical liaison across both hospital and professional billing environments, performing comprehensive reimbursement analysis and developing detailed resolution plans to mitigate institutional revenue leakage. This role drives cross-functional collaboration and fosters constructive relationships between clinical revenue-producing departments and core revenue cycle teams to proactively resolve workflow deficiencies.

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Revenue Cycle Initiative Leadership: Leads complex revenue cycle initiatives and large-scale optimization projects across high-revenue-generating or at-risk clinical departments to improve overall revenue integrity, operational efficiency, and regulatory compliance.
• Project Work Plan Management: Develops and executes detailed project work plans, timelines, and resolution frameworks for complex, multi-departmental revenue initiatives with limited managerial oversight to ensure timely delivery of operational goals.
• Epic System Workflow Validation: Monitors, audits, and validates active charging workflows within Epic and intersecting third-party charging interfaces to ensure technical baseline accuracy and appropriate system build configuration.
• Root Cause Data Analysis: Analyzes Epic work queue data and revenue performance metrics to execute structural root cause analysis, identify localized workflow deficiencies, and present formalized interpretations and actionable findings to leadership.
• Departmental Sourcing Support: Manages charging, coding, and billing processes within clinical departments by auditing revenue-producing activities to verify compliance with evolving government regulations and third-party payer contract requirements.
• Cross-Functional Stakeholder Collaboration: Partners with departmental stakeholders, finance leaders, and revenue cycle teams to assess active clinical workflows, troubleshoot system issues, and deliver targeted training and analytical feedback.
• Subject Matter Expertise & Escalation Support: Serves as the primary functional subject matter expert and institutional liaison for charge capture, supporting complex escalation issues and guiding cross-functional revenue cycle partners.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

REQUIRED EDUCATION AND EXPERIENCE:

Associate’s degree in Business, Healthcare, or a related field; and at least 5 years of healthcare experience, including at least 2 years in an active role involving coding, auditing, finance, revenue cycle management, and/or physician billing (preferably within an Academic Medical Center setting); or equivalent combination of education and experience.

PREFERRED EDUCATION AND EXPERIENCE:

A Bachelor’s degree in Business, Healthcare Administration, or a closely related field, combined with 5 or more years of progressive revenue integrity experience within a matrixed health system.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

Certified Professional Coder (CPC), Certified Coding Specialist – Physician-based (CCS-P), or Certified Professional Medical Auditor (CPMA).

KNOWLEDGE, SKILLS & ABILITIES (KSAs):

• Advanced Process and Root Cause Analysis: Advanced proficiency in process analysis, troubleshooting, and database investigation to structurally isolate billing deficiencies and engineer actionable solutions.
• Healthcare Revenue Cycle Principles: Strong working knowledge of materials management, purchasing, contracting, and vendor management structures as they intersect with hospital charging systems, Epic, and nThrive applications.
• Objective Data Synthesization: Advanced analytical skills to evaluate complex utilization datasets from multiple disparate sources, develop summary metrics, and translate findings into current, accurate procurement and billing recommendations.
• Strategic Communication and Presentation: Superior written and verbal communication skills, including the objective ability to present complex fiscal trends, regulatory interpretations, and systemic recommendations to senior administrative and physician leadership.
• Independent Project Management: Strong organizational and time management skills to manage deadlines, prioritize personal workloads, and autonomously drive multiple concurrent project plans.
• Stakeholder Influence and Interviewing: Strong active listening and interviewing skills to gather relevant workflow data from clinical personnel and establish collaborative working relationships across diverse medical and administrative teams.
• Office Application Competency: Intermediate to advanced proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Forms, to execute automated operational reporting and project tracking.

Compensation Range:

$78,000.00- $113,000.00

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.

NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.

Equal Opportunity Employer/Disabled/Veterans

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