Revenue Cycle Reconciliation & Audit Specialist

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.