Revenue Cycle Reconciliation & Audit Specialist

Job Description

Job Description

Job Duties:

• Perform daily, weekly, and monthly reconciliations of revenue cycle transactions, payments, deposits, credits, refunds, and adjustments.
• Audit payment posting activities to ensure accuracy, completeness, and compliance with established policies and procedures.
• Research and resolve discrepancies involving insurance payments, patient payments, credits, refunds, denials, contractual adjustments, and account balances.
• Reconcile bank deposits, electronic remittances, merchant transactions, lockbox activity, and cash posting records.
• Analyze revenue cycle data to identify trends, variances, errors, and opportunities for process improvement.
• Conduct internal audits of revenue cycle processes and documentation to ensure accuracy and compliance.
• Investigate and resolve reconciliation variances in collaboration with Revenue Cycle, Accounting, Operations, and other departments.
• Maintain detailed audit findings, reconciliation reports, supporting documentation, and records of corrective actions.
• Monitor credit balances and refund activities to ensure timely and accurate resolution.
• Assist with month-end, quarter-end, and year-end reconciliation activities and reporting requirements.
• Prepare and distribute reconciliation, audit, and performance reports for leadership review.
• Support implementation of process improvement initiatives designed to strengthen controls, reduce errors, and improve operational efficiency.
• Identify potential compliance risks and recommend corrective actions when appropriate.
• Participate in system testing, workflow validation, and revenue cycle projects as assigned.
• Ensure confidentiality and security of financial and patient information in accordance with HIPAA and company policies.

Education and Experience: 

• High school diploma or equivalent required. Post-secondary education in Accounting, Finance, Business Administration, Healthcare Administration, or a related discipline is strongly preferred, with a bachelor's degree preferred.
• 3+ years of experience in healthcare revenue cycle, payment posting, reconciliation, auditing, accounting, or related financial operations.
• Experience working with medical billing systems, practice management systems, and electronic remittance files required.
• Experience performing account reconciliations, variance analysis, audits, and financial reviews required.
• Experience supporting multi-site healthcare organizations preferred.
• Advanced proficiency with Microsoft Excel and reporting tools required.
• Experience analyzing large data sets and identifying trends, discrepancies, and process improvement opportunities preferred.

Knowledge, Skills, and Abilities:

• Knowledge of healthcare revenue cycle processes, including payment posting, reconciliations, adjustments, credits, refunds, and reimbursement methodologies.
• Knowledge of healthcare reimbursement methodologies, insurance payments, adjustments, credits, and refunds preferred.
• Strong analytical, auditing, and problem-solving skills with the ability to identify discrepancies, determine root causes, and implement corrective actions.
• Proficiency in Microsoft Excel and data analysis tools, including experience working with large data sets and financial reporting.
• Excellent attention to detail with a commitment to accuracy, compliance, and data integrity.
• Ability to prioritize multiple responsibilities, meet deadlines, and manage competing demands in a fast-paced environment.
• Strong written and verbal communication skills with the ability to collaborate effectively across departments.
• Knowledge of HIPAA, compliance requirements, and best practices for handling sensitive financial and patient information.
• Continuous improvement mindset with the ability to identify process enhancement opportunities and improve operational efficiency.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.