Revenue Cycle Specialist

BHS; Indiana; Remote; USD 65,000 - 90,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to join our team. This remote role requires residency in KY, IN, or IL and focuses on researching denials, performing payor compliance reviews, and securing pre-authorizations to maximize reimbursement.

The specialist will manage pre and post services and billing workflows, ensuring timelines are met and revenue recovery is optimized through multiple channels including letters, emails, and calls.

Qualifications

• Healthcare experience in revenue cycle or related area is required or five years if no bachelor's degree.

Responsibilities

• Research denials from all commercial and governmental payors.
• Perform payor compliance review to determine medical necessity for services and billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond to account reviews with efforts to maximize reimbursement and prevent future revenue loss.

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.