Revenue Analyst II

Cambridge Health Alliance; Massachusetts; On-site; USD 83,000 - 110,000; Full time

Job summary

Cambridge Health Alliance is seeking a Revenue Analyst II to ensure accurate hospital billing and claims processing. The role involves analyzing claims, resolving billing issues, and maintaining compliance with payer guidelines. Join a vibrant healthcare team dedicated to community service and professional growth.

Benefits

medical insurance

vision insurance

paid maternity leave

401(k)

tuition assistance

student loan assistance

disability insurance

Qualifications

• Minimum of 1 year hospital billing experience required.
• Proficiency in Epic systems required.
• Ability to interpret EOBs, Remittance Advices, and CMS 1500 data elements.

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.
• Ensure compliance with regulatory and payer requirements.

Skills

hospital billing

claims management

denials

appeals processes

revenue integrity

Education

CPC (Certified Professional Coder)

Tools

Epic systems

Job description

Direct message the job poster from Cambridge Health Alliance

Human Resources at Cambridge Health Alliance

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!

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Analyst, Quality Assurance, and Finance

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

Paid maternity leave

401(k)

Tuition assistance

Student loan assistance

Disability insurance

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