Revenue Integrity Specialist

Job Summary

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

Key Responsibilities

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

Required Qualifications

• High School Graduate
• Advanced Microsoft Excel skills (e.g., pivot tables, VLOOKUP)
• 3+ years of experience with payer contracts and auditing payments
• Strong understanding of fee schedules and claims payment processes
• Experience with Trizetto EOB resolve tool or similar contract management software