Remote Revenue Cycle Specialist: Denials & Reimbursement

BHS Baptist Healthcare System; Kentucky; Hybrid; USD 50,000 - 70,000; Full time

Job summary

Baptist Health in Kentucky is seeking a Revenue Cycle Specialist for a remote role requiring residency in KY, IN or IL. You will research denials from all payors and conduct payer compliance reviews to ensure medical necessity and correct billing across pre- and post-service steps.

Responsiveness, attention to detail, and proactive communication with payors are essential as you obtain pre-determinations, prior authorizations, and retro authorizations to maximize reimbursement and minimize

Qualifications

• Bachelor's degree or five years of healthcare experience with at least two years in revenue cycle.
• Minimum two years healthcare experience required.

Responsibilities

• Research denials from all commercial and governmental payors.
• Performs payor compliance review on accounts to determine medical necessity and billing validity.
• Obtains pre-determinations, prior authorizations, and retro authorizations when required.
• Responds to payer account reviews to maximize reimbursement and recover revenue.
• Recovery efforts include letters, email, website, and telephone communications.

Skills

Healthcare experience

Payor communication

Denials research

Education

Bachelor's degree

Job description

Baptist Health in Kentucky is seeking a Revenue Cycle Specialist for a remote role requiring residency in KY, IN or IL. You will research denials from all payors and conduct payer compliance reviews to ensure medical necessity and correct billing across pre- and post-service steps.

Responsiveness, attention to detail, and proactive communication with payors are essential as you obtain pre-determinations, prior authorizations, and retro authorizations to maximize reimbursement and minimize