Revenue Integrity A/R Representative
About The Position
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.
Requirements
- 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.
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.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Professional, Scientific, and Technical Services
Education Level
Associate degree
Number of Employees
1,001-5,000 employees
