Remote Revenue Cycle Specialist: Denials & Authorizations

Kyeatright; Kentucky; Remote; USD 55,000 - 75,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to join our team. This remote role requires residency in KY, IN, or IL and offers the chance to work across commercial and governmental payors to research denials and ensure reimbursement.

You will perform payor compliance reviews, determine medical necessity, obtain pre-determinations and authorizations, and respond promptly to reviews to recover revenue while meeting deadlines. Prior revenue cycle experience is preferred.

Qualifications

• Bachelor's degree required or equivalent healthcare experience.
• Minimum two years of healthcare experience; if no degree, five years in healthcare including two years in revenue cycle.
• Experience in revenue cycle areas such as registration, patient financial services, or managed care preferred.

Responsibilities

• Research denials from all commercial and governmental payors.
• Conduct payor compliance reviews to determine medical necessity for services pre/post delivery and pre/post billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when payor requires.
• Respond to account reviews with best efforts to ensure reimbursement and recover revenue while meeting payor/government timelines.
• Recovery efforts include written letters, emails, web interactions, and phone communications.

Skills

Payor knowledge

Denials research

Communication skills

Education

Bachelor's degree

Job description

Baptist Health is seeking a Revenue Cycle Specialist to join our team. This remote role requires residency in KY, IN, or IL and offers the chance to work across commercial and governmental payors to research denials and ensure reimbursement.

You will perform payor compliance reviews, determine medical necessity, obtain pre-determinations and authorizations, and respond promptly to reviews to recover revenue while meeting deadlines. Prior revenue cycle experience is preferred.