Revenue Integrity and Data Specialist

Fairfax Radiology Centers (FRC), LLC•Fairfax, VA

4d•$67,184 - $90,896•Hybrid

About The Position

Fairfax Radiology Centers is seeking an analytical, detail-oriented Revenue Integrity and Data Specialist to join its Revenue Cycle team. The role focuses on identifying reimbursement discrepancies, analyzing financial trends, evaluating external billing vendor performance, and recommending ways to protect revenue and improve processes. The position collaborates with organizational leadership, billing vendors, insurance payers, and internal operational teams. The specialist conducts revenue integrity and underpayment audits; reviews reimbursement, denial, adjustment, and accounts receivable data; validates reports and dashboards; investigates billing and system issues; and quantifies the financial impact of findings. The role also supports vendor oversight, revenue cycle technology and system changes, fee schedule and insurance profile maintenance, payer issue resolution, reimbursement analyses, and internal teams' revenue cycle questions. This is a hybrid, full-time position, initially requiring on-site work 1–2 days per week, with potential for increased remote flexibility based on departmental needs. The annual compensation range is $67,184–$90,896, with placement based on experience, education, certifications, and internal equity. This is an internal posting for current Fairfax Radiology Centers employees only.

Requirements

Bachelor's degree in Healthcare Administration, Health Sciences, Finance, or a related field, plus at least three years of healthcare revenue cycle experience involving reimbursement analysis, denials, accounts receivable, revenue integrity, or billing performance analysis; an equivalent combination of education and experience will be considered.
Advanced Microsoft Excel skills, including PivotTables, XLOOKUP/VLOOKUP or comparable lookup functions, formulas, data reconciliation, data validation, and analysis of large datasets.
Experience developing and analyzing reports, dashboards, and KPIs using Power BI or comparable business intelligence and reporting tools.
Working knowledge of healthcare revenue cycle systems, medical billing workflows, insurance payer requirements, and reimbursement processes.
Experience researching and resolving complex billing discrepancies, reimbursement variances, and payment issues.
Strong analytical, critical-thinking, problem-solving, and organizational skills.
Ability to communicate findings and collaborate effectively with internal and external partners.

Nice To Haves

Professional certification in healthcare billing, coding, reimbursement, or revenue cycle, such as CPC, CRCR, CBCS, CRCS, or a comparable certification.
Experience conducting revenue integrity audits, identifying revenue leakage, or analyzing underpayments.
Experience evaluating external billing vendor performance and revenue cycle KPIs.
Familiarity with system testing, workflow development, data validation, or revenue cycle technology implementations.

Responsibilities

Conduct revenue integrity and underpayment audits to identify reimbursement discrepancies, inappropriate adjustments, billing inaccuracies, and potential revenue leakage.
Analyze reimbursement trends, denial patterns, contractual allowances, write-offs, and other revenue cycle data to identify opportunities for improvement.
Review and validate reports, dashboards, and financial data for accuracy and investigate discrepancies.
Quantify the financial impact of identified issues and recommend corrective actions.
Develop targeted analyses, monitoring tools, and internal controls to strengthen revenue integrity and prevent recurring issues.
Monitor corrective actions to ensure issues are resolved and improvements are sustained.
Evaluate external billing vendor performance using KPIs, account reviews, reporting, and reimbursement trends.
Analyze vendor-processed accounts for billing accuracy, payment performance, denials, adjustments, and account resolution.
Research complex vendor inquiries involving reimbursement variances, payer configuration, denials, and billing discrepancies.
Participate in vendor meetings, share analytical findings, and collaborate on revenue cycle performance improvements.
Serve as a resource to external billing partners on organizational processes, payer requirements, and operational workflows.
Use advanced Excel, Power BI or comparable reporting tools, and revenue cycle systems to analyze large datasets and identify trends.
Investigate system, interface, and workflow issues affecting billing accuracy, reimbursement, or reporting.
Support system upgrades, testing, data validation, configuration changes, and implementation of new revenue cycle technology.
Participate in future EMR/EHR implementations to help ensure accurate workflows, data integrity, and operational readiness.
Maintain accurate fee schedules and insurance profiles to support revenue cycle operations and patient cost estimates.
Identify opportunities to streamline processes, strengthen internal controls, improve reporting, and introduce efficiencies.
Analyze legacy accounts receivable to identify outstanding balances, denials, underpayments, and account resolution opportunities.
Research and resolve complex payer issues, including appropriate follow-up and escalation.
Perform reimbursement analyses and financial modeling to support managed care activities, payer escalations, and contract-related matters.
Validate reimbursement accuracy following payer corrections, contract changes, or system updates.
Support initiatives to resolve outstanding accounts and reduce revenue risk.
Provide timely support to internal teams, including Hospitality Associates, on insurance coverage, payer participation, and reimbursement questions through Microsoft Teams and telephone support.
Research and resolve complex billing, payer, and revenue cycle questions requiring detailed investigation.
Collaborate with internal departments and external partners on special billing arrangements, pricing analyses, and reimbursement-related projects.
Participate in cross-functional initiatives to improve revenue cycle accuracy, efficiency, and performance.