Revenue Integrity Specialist

Job Summary

To support revenue optimization efforts, the full-time Revenue Integrity Specialist will manage reimbursement/payment audits, ensure compliance with payer contracts, and collaborate with various teams to enhance cash flow and audit accuracy.

Key responsibilities

• Auditing provider and care center information for accuracy and compliance with payer agreements
• Conducting Care Center audits and leading initiatives to drive efficiency and revenue opportunities
• Monitoring denial management trends and collaborating with Revenue Cycle Teams to resolve payment issues

Required qualifications

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