Healthcare Revenue Integrity Specialist - Remote

New

Remote (anywhere in the United States)Full-TimeMiddle

Salary25 - 29 USD per hour

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Job Details

Associate’s or bachelor’s degree in accounting, finance, healthcare administration, or related field preferred.
2–3 years of experience in payment reconciliation, healthcare billing, or revenue cycle operations.
Proficiency with EHR/RCM platforms (e.g., Candid, Availity, Waystar).
Proficiency with Excel/Google Sheets.
Proficiency with payment posting systems.
Strong attention to numerical accuracy.
Ability to interpret payer remittance advice.
Comfort with variance analysis.
Understanding of HIPAA.
Understanding of PCI.
Understanding of healthcare payer requirements.
Certifications in Medical Billing & Coding (preferred).
Payment Posting experience (highly desired).
Experience in multi-state telehealth or large outpatient provider environment (preferred).

Reconcile daily payment batches in Candid against bank deposits, resolving unapplied or unmatched items.
Audit claim and payment data for accuracy, proper denial status, and correct payer assignment.
Validate reimbursement amounts against contracted fee schedules and expected payments.
Monitor deposit aging, adjustment codes, and denial patterns; escalate discrepancies or unusual trends.
Maintain accurate reconciliation documentation and ensure audit readiness.
Prepare and share denial feedback and reconciliation summaries to support process improvements.
Verify reconciliations and reports for month-end close and financial accuracy.
Assist with payment integrity projects, such as underpayment reviews and payer audits.
Collaborate with Billing, Quality, and Compliance to refine processes and enhance revenue accuracy.
Present reconciliation findings and payer insights in revenue review meetings.

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