​WellPower is seeking a Revenue Integrity Systems Administrator to ensure the accurate and timely submission of healthcare claims and encounters by managing and optimizing revenue cycle systems. This role is crucial for maintaining data integrity in payer submissions and system configurations, directly supporting the organization’s financial performance.

• ​Location: Denver, Colorado
• ​Compensation: $70,000 – $100,000 per year (Offers typically near the midpoint).
• ​Experience: 3+ years’ experience in Healthcare Claims, Medical Billing, and/or Medical Coding.
• ​Education: Associate degree in Business, Finance, Computer Science, or equivalent experience.
• ​Focus: EHR billing system configuration, claims/encounter submission management (ANSI X12), SQL reporting, and revenue cycle workflow optimization.

​Essential Functions: Configuration, Compliance, and Data Analysis

​The administrator works cross-functionally to ensure the billing systems are configured correctly and compliant with payer and state regulations.

• ​System Configuration & Maintenance: Configure, maintain, and optimize billing system rules, logic, and coding to ensure accurate, timely claims and encounter submissions. This includes managing payer-specific configurations (service codes, rates, modifiers).
• ​Claims & Encounter Management: Manage claims and state encounter submissions, troubleshoot errors, and ensure compliance with ANSI X12 EDI standards. Specifically oversee BHASO state reporting encounters.
• ​EHR Management: Build, test, and maintain EHR system configurations for billing, scheduling, and state reporting requirements. Own critical processes like scheduling calendar code maintenance (PNGP logic).
• ​Reporting & Analysis: Develop dashboards, reports, and system widgets using SQL, DB Visualizer, and UKG to support revenue operations. Analyze billing and encounter data to identify trends, resolve errors, and uncover opportunities for revenue recovery.
• ​Workflow Optimization: Collaborate with Finance, IT, Credentialing, and Quality teams to optimize revenue cycle workflows and automate key processes.

​Required Skills

• ​Industry Experience: 3+ years in Healthcare Claims, Medical Billing, and/or Medical Coding.
• ​Billing Standards: Advanced proficiency in EHR systems, billing platforms, and payer requirements, including ANSI X12 standards.
• ​Reporting Tools: Experience building and analyzing reports using SQL tools (SSMS, DB Visualizer) or Crystal Reports.
• ​Preferred Experience: Experience with accounting and/or nonprofit healthcare billing.