Revenue Integrity & CDM Leader

Boston Medical Center; Baltimore (MD); On-site; USD 89,000 - 161,000; Full time

Job summary

Boston Medical Center seeks an experienced Revenue Integrity Director to lead CDM management and revenue cycle performance. You will oversee charge defense, ensure compliant charging, and collaborate with IT, Epic, coding, and clinical leaders.

The role requires a Bachelor’s degree and 4+ years in CDM leadership, with EPIC expertise preferred. Master’s degree and RN/NP/PA credentials are a plus, offering a high-impact leadership role in a collaborative hospital setting.

Qualifications

• Bachelor’s degree in business administration, Finance or Healthcare Administration.
• Master’s degree preferred (including RN, NP, PA).
• Clinical background as RN, NP, or PA preferred.
• Minimum of four (4) years of clinical experience or 3–5 years in CDM revenue cycle processes.
• Hospital billing and finance background strongly preferred.
• Knowledge of Medicare, Medicaid and other 3rd party billing rules/coverage.
• CPC-H, CPC, or RHIT certification preferred.
• EPIC certification in CDM Management and EPIC Hospital Resolute Billing preferred.
• OREPIC certification, must obtain within 12 months.
• Epic PB Router certification optional.
• RN/PA/NP License preferred.

Responsibilities

• Directs and oversees revenue integrity functions to support accurate, compliant charge capture and revenue cycle performance.
• Monitors charge capture, pre-bill edits, charge reconciliation, and revenue integrity reviews to reduce denials and rework.
• Identifies and resolves revenue integrity risks and compliance issues; escalates as needed.
• Develops tools and reports to identify lost revenue and process improvement needs.
• Liaises with IT, Epic, Coding, Finance and clinical leaders to improve billing efficiency and reimbursement.
• Leads revenue integrity meetings and training for staff and departments.

Skills

Analytical skills

Critical thinking

Communication skills

Motivation

Education

Bachelor’s degree in business administration or Healthcare Administration

Master’s degree preferred (RN/NP/PA)

Tools

Epic CDM Management

Epic Hospital Resolute Billing

Epic PB Router

Epic Revenue Cycle Applications

Microsoft Excel

Tableau

Power BI

SQL-based reporting tools

Crystal Reports

SSRS

Job description

Boston Medical Center seeks an experienced Revenue Integrity Director to lead CDM management and revenue cycle performance. You will oversee charge defense, ensure compliant charging, and collaborate with IT, Epic, coding, and clinical leaders.

The role requires a Bachelor’s degree and 4+ years in CDM leadership, with EPIC expertise preferred. Master’s degree and RN/NP/PA credentials are a plus, offering a high-impact leadership role in a collaborative hospital setting.