Revenue Integrity Specialist
New
United StatesFull-TimeMiddle
Salary$55,000.00-$60,000.00 in base pay
Apply NowOpens the employer's application page
Job Details
- Experience
- 3+ years payer contracts (language) and/or auditing payer payments; 3+ years of experience in a medical billing office preferred.
- Required Skills
- Microsoft ExcelHIPAA
Requirements
- High School Graduate.
- 3+ years experience with payer contracts (language) and/or auditing payer payments.
- Advanced Microsoft Excel skills (pivot tables, VLOOKUP, sort/filtering, formulas).
- Experience working in Trizetto EOB resolve tool or equivalent contract management software.
- Strong analytical skills to identify payment variance and resolve payment issues.
- 3+ years of experience in a medical billing office preferred.
- athenaOne software system experience preferred.
- Must comply with HIPAA rules and regulations.
- Minimum internet speed requirement for remote workers: 5 MBPS download and 3 MBPS upload.
Responsibilities
- Process reimbursement and payment audits in compliance with Privia policies, payer contracts, and government fee schedules.
- Perform audits across systems to ensure accurate provider and care center information.
- Conduct Care Center audits following post-implementation audit policies.
- Lead initiatives to drive efficiency and collaborate with internal stakeholders and commercial payers.
- Make independent decisions regarding audit results and communicate with senior leadership and external parties.
- Create and adhere to escalation processes for issue resolution and action plans.
- Identify, monitor, and manage denial management trends and maintain reference tools on payer policies.
- Assist with Trizetto/Cognizant and fee schedule setup.
View Full Description & ApplyYou'll be redirected to the employer's site
