Senior Revenue Integrity Analyst

🔥 16 hours ago

🇺🇸 United States – Remote

💵 $80k - $95k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Own month-end revenue validation controls, including reconciliation of outputs, exceptions, adjustments, open inventory, and close support schedules • Investigate potential missed, delayed, misstated, or incorrectly billed revenue using paid claim transactional data, invoice detail, contractual terms, and internal financial records • Compare disparate data sources to uncover and apply missed revenue opportunities • Perform and oversee reconciliation of client self-billing files, including data transformation, loading, quality verification, exception analysis, and final invoice support • Review invoicing accuracy and contract alignment; apply non-standard contractual pricing and resolve discrepancies, disputes, and fee paybacks • Support appropriate closure of inventory • Analyze period-over-period movement, inventory aging, throughput, financial data, and other financial variances • Identify root causes of financial underperformance and communicate findings, revenue impact, options, and recommended corrective actions • Lead invoice-detail questions and escalations with internal and external stakeholders • Prepare facts and resolution recommendations for complex client issues • Develop recurring reports, dashboards, forecasts, and insights monitoring KPI and SLA performance, revenue risk, service delivery, and financial accuracy • Partner with Finance, Operations, Technology, and Engineering to reconcile inventory and correct invoicing or revenue application system and process issues • Use Power BI, automation, and agentic tools to improve analytical quality, control effectiveness, cycle time, and operating efficiency • Mentor junior analysts and establish consistent approaches for reconciliations, investigations, documentation, and escalation • Complete annual performance review and/or goal-setting responsibilities • Complete special projects and other assigned duties

🎯 Requirements

• Bachelor's degree in Accounting, Finance, Economics, Business Administration, Engineering, Computer Science, Mathematics, Statistics, or a related field, or an equivalent combination of education, professional training, and relevant work experience • High school diploma or GED required • 5-8 years’ experience in finance, accounting, healthcare payment integrity, revenue cycle or related fields • Strong experience in revenue integrity, revenue cycle management, invoice standards, financial and accounting best practices, inventory management, healthcare payment integrity, and healthcare claims processing • Ability to own multistep month-end controls and resolve complex discrepancies across client-supplied files, invoice detail, and internal financial systems • Advanced Excel and data-analysis skills • Proficiency developing reports and insights in Power BI or similar business intelligence tools • Working knowledge of healthcare payment integrity, claims processing, finance/accounting, and billing cycles • Ability to interpret client-specific invoicing logic and contractual requirements and communicate findings to internal and external stakeholders • Experience collaborating across Finance, Operations, Technology, Engineering, and client-facing teams to implement corrective actions • Strong organization, written communication, client communication, mentoring, and issue-resolution skills • Ability to interpret complex transactional, financial, contractual, and inventory data • Ability to problem-solve and think critically to isolate root causes and determine appropriate corrective actions • Ability to complete complex analyses independently while appropriately escalating material risks and decisions • Ability to make timely decisions within month-end, invoicing, and client-resolution workflows • Ability to maintain focus and manage multiple recurring deliverables, investigations, and deadlines • Ability to assess the accuracy, completeness, and thoroughness of reconciliations, reports, and supporting documentation • Ability to learn and apply new systems, processes, contract terms, and automation approaches • Must be able to perform duties with or without reasonable accommodation • Must be able to provide a dedicated, secure work area • Must be able to provide high-speed internet access / connectivity and office setup and maintenance

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance coverage • 401(k) savings plan • Paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service • Dedicated, secure work area • High-speed internet access / connectivity and office setup and maintenance