Revenue Integrity Specialist

Job Summary

To ensure accurate reimbursement and payment audits, the full-time Revenue Integrity Specialist will manage auditing processes, address payment performance requests, and collaborate with various teams to optimize cash flow in a remote work environment.

Key responsibilities

• Conduct audits to verify accuracy of provider and care center information and reimbursement by payer
• Lead initiatives to drive efficiency and partner with internal and external stakeholders for optimal revenue opportunities
• Identify and manage denial trends while creating reference tools on payer policies

Required qualifications

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