Revenue Integrity Specialist

Job Summary

A company is looking for a Revenue Integrity Specialist to manage reimbursement and payment audits.

Key Responsibilities

• Audit provider and care center information for accuracy and compliance
• Ensure reimbursement accuracy by auditing processed claims according to payer contracts
• Identify and manage denial trends while collaborating with Revenue Cycle Teams and payers

Required Qualifications

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