Revenue Cycle Specialist

BHS; Butlerville (IN); Remote; USD 48,000 - 64,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist for a remote position requiring residency in Kentucky, Indiana, or Illinois. You will research denials, perform payor compliance reviews, and secure pre-authorization steps to maximize reimbursement across commercial and government payors.

Responsibilities include obtaining necessary determinations and responding to reviews to recover revenue while meeting payor timelines.

Qualifications

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

Responsibilities

• Research denials from all payors to determine reimbursement.
• Perform payor compliance review to assess medical necessity of services and timing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond to account reviews to recover revenue and prevent future revenue loss while meeting payor timelines.

Skills

Healthcare experience

Education

Bachelor's degree

Job description

Summary

Job Description:

Baptist Health is looking for a Revenue Cycle Specialist to join our team!

This is a remote work position that requires residency in KY, IN, IL.

The Revenue Cycle Specialist will research denials from all commercial and governmental payors. Performs payor compliance review on accounts to determine medical necessity of services, pre and post service as well as pre and post billing. Obtains pre-determinations, prior authorizations, and retro authorizations when required by payor. Responds to all account reviews with the best possible efforts to ensure reimbursement, recover outstanding revenue, and prevent future revenue loss while meeting all appropriate payor or government timelines. Recovery efforts include but are not limited to written letter, email, web site, and telephonic communication.

Qualifications:

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

Baptist Health is an Equal Employment Opportunity employer.