Revenue Integrity Representative

Role Description

The Revenue Integrity/Data Entry Billing/Charges Representative is responsible for supporting the financial performance of the physician practice by ensuring accurate charge capture, compliant billing, and timely reimbursement. This role works across departments to identify and correct billing discrepancies, reduce denials, and enhance overall revenue cycle efficiency. The ideal candidate demonstrates strong analytical skills, attention to detail, and the ability to manage multiple priorities in a fast-paced healthcare environment. This remote role welcomes candidates anywhere in Canada and the US.

What your impact will be:

• Review physician charges and supporting documentation to ensure accuracy, completeness, and compliance with CPT, ICD-10, and payer-specific guidelines.
• Identify, research, and resolve billing discrepancies and charge capture errors prior to claim submission to minimize denials and rework.
• Manage all aspects of the charge capture process, including ensuring timely authorizations and collaborating with practice staff to obtain missing or corrected information.
• Validate charges for accuracy before release to payers for processing.
• Partner cross-functionally with Accounts Receivable (AR) teams to analyze and address denied claims, ensuring timely resolution and optimal reimbursement outcomes.
• 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.

Qualifications

• 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.

Benefits

• 3 weeks' vacation and 5 personal days
• Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment
• Employee stock ownership and RRSP/401k matching programs
• Lifestyle rewards
• Remote work and more!