Revenue Integrity - Billing/Collections

Druid City Vital Care•Northport, AL

About The Position

The Revenue Integrity is responsible for supporting accurate, compliant, and optimized revenue cycle operations across all franchise locations. This role ensures detailed oversight of the full claim lifecycle, performs advanced revenue analytics, supports audit readiness, and partners with billing teams and vendors to identify revenue risks and improvement opportunities. The position operates under the direction of Revenue Cycle or Finance leadership and plays a critical role in ensuring billing compliance, revenue integrity, and data accuracy in alignment with payer contracts, federal and state regulations, franchise agreements, and ACHC accreditation standards.

Requirements

Bachelor’s degree in Finance, Accounting, Healthcare Administration, Business, or a related field.
3–5 years of experience in revenue cycle management, healthcare billing, revenue integrity, or RCM analytics.
Strong working knowledge of: Healthcare reimbursement and payer adjudication Denials management and appeals Revenue integrity principles HIPAA, CMS, and ACHC accreditation standards
Advanced analytical skills with experience in dashboards, reconciliations, and large datasets.
Strong written and verbal communication skills.
Must be able to sit or stand for extended periods while performing job duties.
Frequent and consistent use of a telephone is required, including handling inbound and outbound.
Ability to use a headset and other telecommunication equipment for extended durations.
Manual dexterity required for dialing, typing, and note-taking during calls.

Nice To Haves

Experience working with outsourced billing partners or multi-location/franchise healthcare organizations preferred.

Responsibilities

Ensure accurate mapping and monitoring of the entire claim lifecycle, including submission, adjudication, denials, appeals, payments, write-offs, refunds, and patient responsibility.
Establish and maintain automated reporting, reconciliation routines, and data validation processes to identify discrepancies, revenue leakage, and opportunities for corrective action.
Review and analyze daily, weekly, and monthly dashboards measuring: Cash collections and posting accuracy Accounts receivable (AR) aging Denial trends and root causes Cash posting and reimbursement variances
Aid in analyzing revenue cycle data to identify risks, trends, payer behaviors, and opportunities for increased reimbursement.
Support audit defense, contract validation, payer reviews, and financial due diligence activities through data analysis, documentation, and reconciliation support.
Prepare and present detailed findings to leadership, highlighting systemic issues, underpayments, compliance concerns, and recommended corrective actions.
Ensure billing and collection practices align with: Payer contracts and reimbursement methodologies Federal and state regulations CMS requirements Franchise agreements and internal policies ACHC accreditation standards
Monitor adjustments, write-offs, refunds, and patient responsibility calculations for consistency and policy compliance.
Oversee and support secure handling of PHI and PII in accordance with HIPAA, CMS, and audit standards.
Aid in developing, documenting, and implementing processes to minimize revenue loss, strengthen revenue capture, and ensure billing compliance across all franchise locations.
Support franchise locations in maintaining compliant financial hardship policies, billing practices, and collection procedures.
Serve as a primary operational liaison with: Vital Care billing leadership Outsourced billing partners Third-party RCM and technology vendors
Monitor service levels, claim turnaround times, denial management performance, and cash posting accuracy.
Track, document, and escalate unresolved issues or high-risk discrepancies to revenue cycle leadership, compliance, legal, or executive teams as appropriate.
Maintain productive working relationships with franchisor RCM teams, system support resources, and franchise leaders to support consistent and compliant revenue operations.
Lead assigned initiatives to improve claim accuracy, reduce days in AR, strengthen payer reimbursement, and minimize denials and inappropriate adjustments.
Collaborate with intake, authorization, clinical, operations, system support, and finance teams to ensure data integrity from referral through cash application.
Identify workflow inefficiencies and deploy automation solutions (RPA, ETL processes, data integration tools) to streamline workflows, improve accuracy, and reduce manual effort.
Support the development and maintenance of standardized reporting, workflows, and best practices aligned with ACHC standards.