Revenue Integrity Specialist

A company is looking for a Revenue Integrity Specialist responsible for processing reimbursement/payment audits and maximizing cash flow. Key Responsibilities Audit provider and care center information for accuracy and compliance Ensure reimbursement accuracy by auditing payer processed claims and conducting Care Center audits Identify and manage denial trends while collaborating with revenue cycle teams and payer representatives Required Qualifications High School Graduate Advanced Microsoft Excel skills (e.g., pivot tables, VLOOKUP) 3+ years of experience with payer contracts and/or auditing payments Experience with Trizetto EOB resolve tool or equivalent contract management software 3+ years of experience in a medical billing office preferred

May 20, 2025 - 04:30

A company is looking for a Revenue Integrity Specialist responsible for processing reimbursement/payment audits and maximizing cash flow. Key Responsibilities Audit provider and care center information for accuracy and compliance Ensure reimbursement accuracy by auditing payer processed claims and conducting Care Center audits Identify and manage denial trends while collaborating with revenue cycle teams and payer representatives Required Qualifications High School Graduate Advanced Microsoft Excel skills (e.g., pivot tables, VLOOKUP) 3+ years of experience with payer contracts and/or auditing payments Experience with Trizetto EOB resolve tool or equivalent contract management software 3+ years of experience in a medical billing office preferred