Cambridge Health Alliance is a nationally recognized, award-winning health system serving communities in Cambridge, Somerville, and Boston's metro-north region. We are a vibrant, innovative healthcare system committed to providing the highest quality of care to our diverse communities. We believe in fostering a culture of excellence, compassion, and collaboration to support both our patients and our staff.
The Revenue Analyst II plays a critical role in ensuring accurate hospital billing, claims processing, and revenue cycle integrity. This position supports pre-claim review, denial resolution, payer communications, and provider enrollment processes, with a focus on enhancing payment accuracy and operational efficiency across inpatient and outpatient hospital services.
Key Responsibilities:
- Analyze and resolve assigned pre-claim edits to ensure clean claim submission
- Investigate and address claim rejections and denials through appeal or adjustment strategies
- Identify recurring issues and trends in claim submission or payer responses
- Process and resolve complex billing issues for inpatient and outpatient services
- Contact payers, patients, and internal departments to support timely account resolution
- Manage incoming correspondence and phone inquiries related to billing discrepancies
- Maintain awareness of managed care contracts and payer guidelines to support correct claim adjudication
- Navigate patient accounting systems to review and manage account details
- Maintain and update provider enrollment records; resolve claim edits related to enrollment
- Ensure compliance with regulatory and payer requirements, contributing to accurate revenue capture
Qualifications:
- Minimum of 1 year hospital billing experience required
- Proficiency in Epic systems required
- Strong working knowledge of hospital billing, claims management, denials, appeals processes, and revenue integrity
- Ability to interpret EOBs, Remittance Advices, and CMS 1500 data elements
- CPC (Certified Professional Coder) preferred
Why CHA?
At Cambridge Health Alliance, you will be part of a diverse and dedicated team making a difference in the lives of our patients and the communities we serve. We offer a highly collaborative environment, professional development opportunities, and a strong benefits package including medical, dental, retirement, and generous paid time off.
How to Apply:
If you feel this opportunity would be a great fit, we encourage you to apply today by submitting your full application on our CHA Careers portal here