Revenue Integrity Specialist - Remote

Overview

The Revenue Integrity Specialist will manage charge review, claim, and denial edits to ensure compliance with billing rules while maximizing reimbursement. This role involves working with Revenue Cycle leadership and optimizing the use of Epic's Revenue Guardian module.

In Short

• Review charge and claim edits for compliance.
• Work with Revenue Cycle leadership for software optimization.
• Monitor trends in billing edits.
• Provide training and optimization feedback.
• Manage payor and claim edits accurately.
• Analyze denials and follow-up activities.
• Maintain knowledge of payer policies.
• Perform root-cause analysis on billing issues.
• Support Revenue Cycle leadership as needed.
• Prioritize work to meet payer deadlines.

Requirements

• High School Diploma or equivalent.
• Two years of billing-revenue cycle experience.
• Bachelor’s degree in business or health-related field preferred.
• Knowledge of medical terminology and coding.
• Strong analytical and communication skills.
• Experience with Microsoft Excel and reporting tools.
• Understanding of reimbursement policies and regulations.

Benefits

• Competitive salary.
• Comprehensive health benefits.
• Opportunities for professional development.
• Supportive work environment.
• Work-life balance initiatives.