Revenue Integrity Authorization Specialist

Capital Health System, Inc.; Princeton (NJ); On-site; USD 74,000 - 97,000; Full time

Benefits offered by this job

Medical Plan

Prescription drug coverage

Dental Plan

Vision Plan

Paid Time-Off

Job summary

Capital Health System, Inc. in New Jersey seeks a Revenue Integrity Specialist focused on pre-service authorization and post-procedure pre-bill validation to ensure services align with authorizations.

You will collaborate with Central Scheduling, clinical departments, and payer portals; RN license preferred; 3 years in hospital revenue cycle and pre-bill workflows desired. The role offers a full-time schedule of 40 hours per week with pay range $35.69–$46.63 hourly; comprehensive benefits and

Qualifications

• Strong knowledge of payer authorization requirements, including CPT/HCPCS, units, date range, site of service, and level of care dependencies.
• Understanding of hospital claim flow and pre-bill controls.
• Experience with prior-authorizations and post-service pre-bill workflows.

Responsibilities

• Performs pre-service authorization integrity review for scheduled high-risk accounts.
• Verifies authorization elements (payer, CPT/HCPCS, units, date span, site/setting).
• Performs post-procedure pre-bill authorization validation and reconciles mismatches.
• Initiates correction workflows with Central Scheduling and clinical departments.
• Applies hold/release standards for unresolved risk before billing finalization.
• Documents findings in work queues and communicates with downstream teams.

Skills

Payer authorization

Pre-bill review

Revenue Integrity

Excel

Payer portals

Education

High school diploma

RN license preferred

Tools

EHR

Payer portals

Microsoft Excel

Job description

Capital Health System, Inc. in New Jersey seeks a Revenue Integrity Specialist focused on pre-service authorization and post-procedure pre-bill validation to ensure services align with authorizations.

You will collaborate with Central Scheduling, clinical departments, and payer portals; RN license preferred; 3 years in hospital revenue cycle and pre-bill workflows desired. The role offers a full-time schedule of 40 hours per week with pay range $35.69–$46.63 hourly; comprehensive benefits and