Remote Revenue Cycle Specialist: Denials & Payor Compliance

Baptist Health; Louisville (KY); Remote; USD 55,000 - 75,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to join our team. This is a remote work position that requires residency in KY, IN, IL.

The role involves researching denials from all payors, performing payor compliance reviews, and obtaining pre-determinations and authorizations as required. You will respond to reviews and work to recover revenue while meeting timelines across payors.

Qualifications

• Bachelor's degree or equivalent healthcare experience.
• Minimum of two years healthcare experience.
• In lieu of Bachelor's degree, five years healthcare experience including two years in revenue cycle related area such as registration, patient financial services, or managed care.

Responsibilities

• Research denials from commercial and governmental payors and perform payor compliance review to determine medical necessity and pre/post service as well as pre/post billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond to account reviews and pursue recovery of revenue while meeting payor/government timelines.

Skills

Healthcare revenue cycle knowledge

Education

Bachelor's degree

Job description

Baptist Health is seeking a Revenue Cycle Specialist to join our team. This is a remote work position that requires residency in KY, IN, IL.

The role involves researching denials from all payors, performing payor compliance reviews, and obtaining pre-determinations and authorizations as required. You will respond to reviews and work to recover revenue while meeting timelines across payors.