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. The Revenue Integrity Specialist works collaboratively with clinical, coding, billing, operational, and revenue cycle teams to identify, investigate, and resolve issues impacting charge capture, claim accuracy, reimbursement, operational efficiency, and clean claim submission while supporting revenue integrity and operational improvement initiatives.

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.
• Assist 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
• Why You'll Love Working With Us
• Collaborative team environment that encourages professional growth
• Urgent care services at no cost to our team members and their families
• Extensive benefit offerings including health, dental, and vision coverage, company paid short-term disability, and optional pet insurance
• 401k match after one year of service
• Access to our primary care (depending on location)
• Educational Alliance with Purdue University Global and reduced tuition rates for team members and their families
• Employer rewards and access to discounts offered on services and products such as hotels, travel, entertainment, restaurants, and more
• It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Benefits

Additional Information

At ConvenientMD , we're on a mission to make good health more convenient for all - working to improve how patients and providers experience healthcare in New England. To support this belief, we're building a team of dedicated professionals who genuinely care about improving lives, are passionate about work that can make a difference, and are driven to learn from one another.

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