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.

Qualifications:

·         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.