Revenue Integrity Systems Administrator

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Position Summary :

The Revenue Integrity Systems Administrator is responsible for the implementation, configuration, maintenance, and optimization of systems that support accurate claim and encounter submissions across WellPower. This role works cross-functionally with the Accounting, Information Systems, Credentialing, Front Office, HISM, Training, and Quality Systems teams. It ensures data integrity in payer submissions, system builds, and reporting processes that directly support revenue cycle performance.

The Administrator leverages tools such as MS SQL Server, DB Visualizer, and UKG to validate data, manage configurations, and troubleshoot system errors. This role has responsibility for report development, state reporting files, and internal workflow logic that was previously supported by other departments (e.g., Information Systems).

Learn more about WellPower :

Compensation and Benefits :

• $70,000 - $100,000 per year

WellPower is committed to fair and equitable hiring with salaries based on relevant factors, such as work experience, education, and certification / licensure (rather than wage history). Toward the principle of equal pay for equal work, we post and hire within defined hiring salary ranges. We ask all applicants to carefully review the hiring salary range for each posted job opportunity, as we will not hire outside the predetermined range.

All full-time, benefits eligible employees will be eligible for WellPower's benefits plan. For a full description of benefit offerings, please visit : https : / / WellPower.org / workplace-of-choice / .

ESSENTIAL JOB FUNCTIONS :

Manage and monitor healthcare claim and state encounter submissions to ensure timely, accurate reporting. Troubleshoot submission errors and apply ANSI X12 EDI standards to maintain compliance with payer requirements. Maintain payer-specific configurations including service codes, rates, modifiers, and error resolution logic.

Build, test, and maintain EHR system configurations related to billing, scheduling, and state reporting requirements. Maintain and update system rules and logic in response to changes in payer policies or organizational needs. Collaborate with internal and external stakeholders to support ongoing system enhancements and upgrades.

Oversee configuration and maintenance of BHASO state reporting encounters. Ensure correct formatting and transmission of required files in compliance with state requirements.

Develop system widgets, dashboards, and reports to support revenue cycle operations and reduce revenue leakage. Leverage tools such as SQL, DB Visualizer, and UKG reporting tools to analyze data and identify trends.

Own key processes such as the PNGP logic and scheduling calendar code maintenance. Coordinate with teams including Credentialing, Billing, and Information Systems to ensure data alignment across systems and workflows.

Recommend workflow improvements and system updates to support business goals. Document processes and configurations to support continuity and knowledge sharing within the team.

REQUIRED QUALIFICATIONS :

Education :

Experience :

Typical Physical and Mental Demands :

Requires sitting, standing, bending and reaching. May require lifting up to 50 pounds. Requires manual dexterity sufficient to operate standard office machines such as computers, fax machines, the telephoneand other office and / or clinical equipment.

Working Conditions :

May require occasional evening or weekend hours upon request.

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