Priviahealth

Priviahealth

Revenue Integrity Specialist

Remote, USA, United States

Sponsorship not specified$55k-$60kDetected 14 days ago
ComplianceSalesforceExcelAuditingContract ManagementAR/VRHIPAALeadership

About the role

  • Manager, Revenue Optimization the Revenue Integrity Specialist is responsible for complete, accurate and timely processing of reimbursement/payment audits in compliance with Privia policies, payer contracts and government fee schedules.
  • This position works collaboratively with our operations consultants, RCM AR staff and management.
  • The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Requirements

  • Work with your internet provider if you have questions about your connection.

Skills

  • Auditing across all systems to ensure new provider and care center information is accurate
  • Ensure reimbursement by payer is accurate per payer contract agreements, government and state rates by auditing payer processed claims
  • Conduct Care Center audits following the audit policy based on the number of providers on a 30/60/90/120 post implementation/go-live date
  • Assist with Trizetto/Cognizant setup, fee schedule setup
  • Work and address Salesforce cases along with athenaOne tables
  • 3+ years payer contracts (language) and/or auditing payer payments required
  • Experience working in Trizetto EOB resolve tool or equivalent use of contract management/software preferred
  • Availity portal experience preferred
  • Salesforce case management experience preferred
  • AthenaOne software system experience is preferred
  • Must comply with HIPAA rules and regulations

Compensation

  • $55k-$60k

This listing is sourced directly from Priviahealth's careers page and normalized into a canonical job model.