Revenue Cycle Systems Architect

Community Care Cooperative • Boston, MA

4d • $102,561 - $125,638 • Hybrid

About The Position

The Revenue Cycle Systems Architect is responsible for the design and optimization of the revenue cycle systems that support our FQHC customers. This role ensures that Epic and integrated revenue systems operate as a cohesive, compliant, and scalable system enabling accurate charge capture, clean claim generation, effective remittance processing, and dependable financial reporting. This position is best suited for an Epic revenue cycle expert with knowledge of Epic workflows in Resolute Professional Billing, Charge router, charge capture, SBO and Ambulatory. This role requires expertise in implementing, optimizing, and supporting end-to-end billing, registration and clinical workflows within FQHCs or complex multi-site organizations. Collaboration with Revenue Integrity, Billing/AR, Clinical Operations, Finance, IT, and customer-facing operational teams is essential.

Requirements

• Epic expertise in Resolute PB, Charge Router, Ambulatory, Claims & Remittance, work queue design, data extracts and reporting
• Demonstrated leadership and ability to guide complex system builds, optimizations, and implementations
• Excellent communication skills, analytical thinking, and cross-functional collaboration abilities
• Ability to manage multiple projects simultaneously in a fast-paced, evolving environment
• Expertise with Microsoft Office Suite
• Results driven and outcome focused
• Must be innovative, comfortable with ambiguity, well-organized, and committed to moving quickly and collaboratively in the context of a rapidly changing organization
• Experience with quality improvement/change management and project management
• Proficiency in Microsoft Office Suite
• Must have a strong commitment to quality assurance and exceptional customer service
• A strong commitment to the organization’s mission

Nice To Haves

• Epic revenue cycle certifications (Charge Router, PB/Resolute, EpicCare Ambulatory or related Epic modules)
• Familiarity with the MassHealth ACO program
• Experience working in Federally Qualified Health Centers (FQHCs)
• Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Responsibilities

• Create and maintain sustainable processes in Epic, including charge build, error resolution, and revenue enhancement
• Conduct audits of charge routing workflows and implement corrective actions to eliminate recurring issues
• Act as the primary Epic Professional Billing (PB) and charge router subject-matter expert for revenue cycle initiatives
• Build and refine Epic workqueues, charge router rules, claims edits, handler tasks and PB configuration
• Partner with IT and Epic support (CTC) to troubleshoot issues, develop enhancements, and support system upgrades
• Lead testing strategies (Integrated charging and Scenario testing) to validate system build and ensure accuracy
• Identifies process and technology improvements to improve the effectiveness and efficiency of revenue cycle operations
• Provide consulting services to individual FQHCs to identify areas of focus to improve revenue cycle operations
• Develop dashboards and reporting tools to track key revenue integrity metrics, such as denials and charge accuracy
• Provide detailed analysis and insights to leadership, recommending improvements to optimize revenue cycle performance
• Monitor denial patterns and lead cross-functional corrective action plans in collaboration with Billing/AR
• Support payer transitions, FQHC expansions, and new revenue cycle initiatives
• Develop training programs focused on documentation standards, Epic workflows, coding accuracy, and payer compliance
• Collaborate with Billing/AR, Finance, Clinical, Compliance, and IT teams to ensure consistent and compliant revenue cycle practices
• Collaborates with internal and external constituents to execute improvements
• Serve as a trusted advisor across departments, leveraging in-depth system knowledge to enhance operational efficiency
• Analyzes data to identify opportunities for revenue growth and process enhancements
• Works closely with vendors and other third parties to facilitate timely and accurate data capture and collections
• Represents the billing department in audits, meetings, and organizational planning sessions
• Consistently provides service excellence to all patients, family members, visitors, volunteers, and co-workers in a manner that reflects C3’s mission and core values
• Contribute to shaping the vision for C3 as the preferred resource for an affordable and efficient MSO in Billing and Credentialing
• Perform other duties as assigned

Benefits

• In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager