Remote Revenue Cycle Specialist: Denials & Reimbursements

BHS; Central City (KY); Remote; USD 55,000 - 75,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to optimize denials research and payor compliance across commercial and governmental payors. This remote position requires residency in KY, IN, or IL and offers the opportunity to impact revenue cycles while communicating across payors and care teams.

Responsibilities include obtaining pre-determinations, prior authorizations, and retro authorizations as needed, and responding to account reviews by pursuing best possible recovery and avoiding

Qualifications

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

Responsibilities

• Research denials from all commercial and governmental payors.
• Perform payor compliance review on accounts to determine medical necessity of services, pre and post service as well as pre and post billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond to all account reviews with efforts to maximize reimbursement and recover outstanding revenue.
• Support recovery efforts to prevent future revenue loss while meeting payor/government timelines.

Skills

Healthcare experience

Education

Bachelor's degree

Job description

Baptist Health is seeking a Revenue Cycle Specialist to optimize denials research and payor compliance across commercial and governmental payors. This remote position requires residency in KY, IN, or IL and offers the opportunity to impact revenue cycles while communicating across payors and care teams.

Responsibilities include obtaining pre-determinations, prior authorizations, and retro authorizations as needed, and responding to account reviews by pursuing best possible recovery and avoiding