Revenue Integrity A​/R Representative

Key Responsibilities:

• Review physician charges and supporting documentation for accuracy, completeness, and compliance with CPT, ICD-10, and payer guidelines.
• Identify, research, and resolve billing and charge capture errors prior to claim submission.
• Manage AR aging reports and follow up on unpaid, underpaid, or denied claims to ensure timely collections.
• Collaborate with coding, billing, and clinical teams to prevent recurring errors and improve charge capture processes.
• Analyze denial trends and develop recommendations for process improvement.
• Conduct internal audits to support revenue integrity and compliance with payer contract terms.
• Prepare and maintain reports tracking reimbursement performance, collection activity, and outstanding balances.
• Stay current with payer policies, physician billing regulations, and healthcare reimbursement trends.

• Associate or Bachelor’s degree in Accounting, Business, Healthcare Administration, or related field (or equivalent work experience).
• Minimum of 2 years of experience in physician billing, AR management, or revenue integrity.
• Strong knowledge of medical terminology, CPT/ICD-10 coding, and payer reimbursement methodologies.
• Proficiency in electronic health record (EHR) and billing systems (e.g., Epic, Athena, eClinicalWorks, or similar).
• Intermediate proficiency in Microsoft Excel
  , including pivot tables, data analysis, and reporting.
• Project management skills
  , including the ability to coordinate process improvement initiatives and track performance outcomes.
• Excellent analytical, organizational, and communication skills.
• Strong attention to detail with the ability to work both independently and collaboratively.