Revenue Integrity Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Reconcile daily payment batches in Candid with bank deposits, addressing any unapplied or unmatched items.

• Conduct audits on claims and payment data to ensure accuracy, appropriate denial status, and correct payer assignment.

• Validate reimbursement amounts against contracted fee schedules and anticipated payments.

• Monitor deposit aging, adjustment codes, and denial trends; escalate any discrepancies or unusual patterns.

• Maintain precise reconciliation documentation to guarantee audit readiness.

• Prepare and distribute denial feedback and reconciliation summaries to facilitate process improvements.

• Verify reconciliations and reports for month-end closings and financial accuracy.

• Assist with payment integrity initiatives, including underpayment reviews and payer audits.

• Collaborate with Billing, Quality, and Compliance teams to refine processes and improve revenue accuracy.

• Present findings from reconciliations and payer insights during revenue review meetings.

⛳️ Requirements

• Education/Experience: An associate’s or bachelor’s degree in accounting, finance, healthcare administration, or a related field is preferred.

• Experience: 2–3 years in payment reconciliation, healthcare billing, or revenue cycle operations is required.

• Technical Skills: Proficiency in EHR/RCM platforms (e.g., Candid, Availity, Waystar), Excel/Google Sheets, and payment posting systems.

• Analytical Skills: Strong focus on numerical accuracy, ability to interpret payer remittance advice, and comfort with variance analysis.

• Regulatory Knowledge: Familiarity with HIPAA, PCI, and healthcare payer requirements.

• Preferred: Experience in a multi-state telehealth or large outpatient provider setting. Any Medical Billing/Coding Certifications. Any Payment Posting experience is highly valued.

🏝️ Benefits

• Exceptional paid time off policies that promote and support work-life balance, including a winter break.

• 401k matching to ensure our team members have the resources they need for a comfortable retirement.

• Health insurance options that promote well-being for individuals and their families.

• Company-paid life, short-term disability, and long-term disability coverage.

• A remote work environment that emphasizes connectivity through professional collaboration and personal relationships.