Revenue Integrity Specialist
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About The Position
As a Revenue Integrity Specialist (RIS) at R1, you will play a crucial role in ensuring the accuracy of payments received from various payor plans. Your primary responsibility will be to identify underpaid payment discrepancies when the posted payment does not align with the expected payment as per the insurer's contract. This position requires you to work within the underpayment department, collaborating closely with the billing and follow-up teams to resolve discrepancies effectively. In this full-time remote role, you will analyze assigned accounts daily from the payment discrepancy work queues, validating discrepancies against contract terms. You will assign appropriate reason codes, sub-status codes, and root cause reasons for discrepancies, ensuring that all account balances are reconciled accurately. Additionally, you will be responsible for contacting insurance companies regarding underpaid accounts, collecting the underpaid portions of claims, and submitting reconsideration or contractual appeal letters when necessary. Your analytical skills will be put to the test as you interpret and calculate payor contract reimbursement methodologies, prepare detailed Excel analyses using VLookups and pivot tables, and research billing questions to ensure appropriate revenue recognition. You will also analyze data to identify relationships, summarize findings, and prepare materials for discussions with clinical and finance teams. This role requires strong time management skills, the ability to manage multiple tasks simultaneously, and a self-directed approach to work. To thrive in this position, you must possess intermediate knowledge of Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook. Strong interpersonal and problem-solving skills are essential, as is the ability to work independently under pressure with minimal supervision. You will also need to be up to date on all vaccinations, including the annual flu shot, and pass a background check and drug screen before starting your role.
