Revenue Integrity Specialist
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Job Summary
Managing charge reviews and claim edits, the full-time Revenue Integrity Specialist will ensure compliance with billing rules and maximize reimbursement while working remotely.
Key responsibilities
- Manages payor and claim edits related to CCI, OCE, MUE, LCD, and NCD in a compliant manner
- Tracks and reports on edited accounts and denial appeals, communicating trends to Revenue Cycle leadership
- Collaborates with clinical departments and revenue cycle leadership to optimize charge capture and compliance
Required qualifications
- High School Diploma or equivalent
- Two years of billing or revenue cycle experience
- Knowledge of medical terminology and coding (ICD-10, CPT, HCPCS)
- Understanding of payer policies and government regulations related to billing
- Proficiency in Microsoft Excel and reporting tools
Complete Job Description
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