Senior Revenue Integrity Analyst

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

📋 Description

• Take charge of month-end revenue validation processes, which includes the reconciliation of outputs, handling exceptions, making adjustments, managing open inventory, and facilitating close support schedules.

• Explore potential instances of missed, delayed, misstated, or inaccurately billed revenue by analyzing paid claim transactional data, invoice details, contractual terms, and internal financial documentation.

• Compare diverse data sources to identify and leverage missed revenue opportunities.

• Execute and supervise the reconciliation of client self-billing files, which encompasses data transformation, loading, quality verification, exception analysis, and supporting final invoices.

• Assess invoicing accuracy and ensure alignment with contracts; implement non-standard contractual pricing and resolve any discrepancies, disputes, and fee paybacks.

• Assist in the appropriate closure of inventory.

• Analyze movement from period to period, inventory aging, throughput, financial data, and other financial variances.

• Pinpoint root causes of financial underperformance and convey findings, revenue impacts, options, and recommended corrective actions.

• Lead inquiries and escalations regarding invoice details with both internal and external stakeholders.

• Compile facts and resolution suggestions for intricate client issues.

• Create recurring reports, dashboards, forecasts, and insights to monitor KPI and SLA performance, revenue risk, service delivery, and financial accuracy.

• Collaborate with Finance, Operations, Technology, and Engineering teams to reconcile inventory and rectify issues related to invoicing or revenue application systems and processes.

• Utilize Power BI, automation, and agentic tools to enhance analytical quality, control effectiveness, cycle time, and operational efficiency.

• Mentor junior analysts and establish uniform methods for reconciliations, investigations, documentation, and escalations.

• Fulfill annual performance review and/or goal-setting responsibilities.

• Undertake special projects and additional assigned tasks.

⛳️ Requirements

• A Bachelor’s degree in Accounting, Finance, Economics, Business Administration, Engineering, Computer Science, Mathematics, Statistics, or a related field, or an equivalent combination of education, professional training, and relevant work experience.

• A high school diploma or GED is required.

• 5-8 years of experience in finance, accounting, healthcare payment integrity, revenue cycle, or related fields.

• Strong expertise in revenue integrity, revenue cycle management, invoicing standards, financial and accounting best practices, inventory management, healthcare payment integrity, and healthcare claims processing.

• Ability to manage multistep month-end controls and resolve intricate discrepancies across client-supplied files, invoice details, and internal financial systems.

• Advanced skills in Excel and data analysis.

• Proficiency in developing reports and insights using Power BI or similar business intelligence tools.

• Working knowledge of healthcare payment integrity, claims processing, finance/accounting, and billing cycles.

• Capability to interpret client-specific invoicing logic and contractual requirements, and effectively communicate findings to both internal and external stakeholders.

• Experience in collaborating across Finance, Operations, Technology, Engineering, and client-facing teams to implement corrective actions.

• Strong organizational, written communication, client communication, mentoring, and issue-resolution skills.

• Ability to interpret complex transactional, financial, contractual, and inventory data.

• Competence in problem-solving and critical thinking to identify root causes and establish appropriate corrective actions.

• Ability to perform complex analyses independently while appropriately escalating significant risks and decisions.

• Capacity to make timely decisions within month-end, invoicing, and client-resolution workflows.

• Proficiency in maintaining focus and managing multiple recurring deliverables, investigations, and deadlines.

• Ability to evaluate the accuracy, completeness, and thoroughness of reconciliations, reports, and supporting documentation.

• Capability to learn and apply new systems, processes, contract terms, and automation methods.

• Must be able to perform duties with or without reasonable accommodation.

• Must provide a dedicated and secure work area.

• Must have high-speed internet access/connectivity and maintain an office setup.

🏝️ Benefits

• Medical insurance

• Dental insurance

• Vision insurance

• Disability insurance

• Life insurance coverage

• 401(k) savings plan

• Paid family leave

• 9 paid holidays per year

• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service

• Dedicated, secure work area

• High-speed internet access/connectivity and office setup and maintenance