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