Revenue Integrity Specialist
About the role
The Revenue Integrity Specialist supports the accuracy, completeness, and timeliness of charge capture, coding, and billing processes across ConvenientMD service lines, including Urgent Care, Advanced Primary Care, and Laboratory services. This role supports operational revenue cycle workflows through charge review, billing issue resolution, claim validation, operational monitoring, and workflow support activities designed to ensure accurate claim submission, billing integrity, and reimbursement performance across front-end, mid-cycle, and back-end revenue cycle processes.
Responsibilities
- Collect, verify, and enter charge data related to patient services and procedures.
- Review clinical documentation to ensure services performed are accurately reflected in billing records.
- Confirm coding accuracy and alignment with CPT and ICD-10 standards.
- Investigate missing or incomplete charges and collaborate with clinical teams to resolve discrepancies.
- Maintain detailed documentation supporting billing accuracy and regulatory compliance.
- Monitor charge capture workflows to identify trends, gaps, or opportunities for improvement.
- Partner with billing and coding teams to support timely and accurate claims submission.
- Aid in educating clinical and administrative staff on charge capture workflows and best practices.
- Stay current on payer requirements, billing regulations, and coding updates.
- Generate reports and insights that support revenue integrity and operational improvement.
Requirements
Healthcare revenue cycle experience: 2+ years of experience in healthcare revenue cycle, billing, charge capture, coding support, healthcare operations, or a related field.
Systems knowledge: Experience with EMR, billing, or revenue cycle systems.
Knowledge of payer requirements: Basic knowledge of CPT, HCPCS, ICD-10 coding concepts and payer billing requirements.
Revenue cycle knowledge: Knowledge of charge capture workflows and revenue cycle processes.
Analytical and problem-solving skills: Strong organizational, analytical, and problem-solving skills.
Investigative mindset: Ability to investigate issues, identify patterns, and support operational resolution.
Attention to detail: Strong attention to detail and ability to manage multiple priorities in a fast-paced environment.
Communication and collaboration skills: Effective communication and collaboration skills.
Qualifications
High school diploma or equivalent required.
Bachelor’s degree in healthcare administration, business, or a related field preferred.
Skills
Strong understanding of CPT, HCPCS, and ICD-10 coding concepts.
Experience with EMR, billing, or revenue cycle systems.
Excellent organizational and analytical skills.
Ability to work independently and as part of a team.
Benefits
Access to our primary care (depending on location).
Educational Alliance with Purdue University Global and reduced tuition rates for team members and their families.
401(k) match after one year of service.
Pay
Competitive salary based on experience and qualifications.
Schedule
Full-time position.