Revenue Integrity Specialist

Job Summary

A company is looking for a Revenue Integrity Specialist responsible for processing reimbursement/payment audits and maximizing cash flow.

Key Responsibilities

• Audit provider and care center information for accuracy and compliance
• Ensure reimbursement accuracy by auditing payer processed claims and conducting Care Center audits
• Identify and manage denial trends while collaborating with revenue cycle teams and payer representatives

Required Qualifications

• High School Graduate
• Advanced Microsoft Excel skills (e.g., pivot tables, VLOOKUP)
• 3+ years of experience with payer contracts and/or auditing payments
• Experience with Trizetto EOB resolve tool or equivalent contract management software
• 3+ years of experience in a medical billing office preferred