Revenue Integrity Specialist

Job Summary

A company is looking for a Revenue Integrity Specialist responsible for auditing and ensuring accurate reimbursement processes.

Key Responsibilities

• Conduct audits to ensure accuracy of provider and care center information and reimbursement by payer
• Lead initiatives to drive efficiency and collaborate with internal and external partners for optimal revenue opportunities
• Monitor denial management trends and assist with setup and management of relevant software tools

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 preferred