Remote Revenue Cycle Specialist: Denials & Reimbursements

BHS; Illinois; Remote; USD 50,000 - 65,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist for a remote position requiring residency in Kentucky, Indiana, or Illinois. The role focuses on researching denials, performing payor compliance reviews, and securing pre-determinations and authorizations to maximize reimbursement.

Responsibilities include addressing payor reviews, pursuing recoveries, and ensuring timeliness with payor deadlines. A Bachelor's degree or equivalent healthcare experience is required.

Qualifications

• This role requires a Bachelor's degree or five years of healthcare experience with two years in revenue cycle.
• Experience researching denials from commercial and governmental payors.
• Ability to obtain pre-determinations and prior authorizations as required by payor.

Responsibilities

• Research denials from all commercial and governmental payors.
• Perform payor compliance review to determine medical necessity and related timelines.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond to account reviews to recover revenue and minimize future losses.

Skills

Healthcare experience

Denials research

Attention to detail

Negotiation

Education

Bachelor's degree

Job description

Baptist Health is seeking a Revenue Cycle Specialist for a remote position requiring residency in Kentucky, Indiana, or Illinois. The role focuses on researching denials, performing payor compliance reviews, and securing pre-determinations and authorizations to maximize reimbursement.

Responsibilities include addressing payor reviews, pursuing recoveries, and ensuring timeliness with payor deadlines. A Bachelor's degree or equivalent healthcare experience is required.