Revenue Cycle Specialist

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

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.

Baptist Health is an Equal Employment Opportunity employer.

Responsibilities

• 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.

Founded in 1924 in Louisville, Kentucky, Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves. The Baptist Health family consists of 10 hospitals, employed and independent physicians, and more than 470 points of care, including outpatient facilities, physician practices and services, urgent care clinics, outpatient diagnostic and surgery centers, home care, fitness centers, and occupational medicine and physical therapy clinics. Baptist Health’s eight owned hospitals include more than 2,300 licensed beds in Corbin, Elizabethtown, La Grange, Lexington, Louisville, Paducah, Richmond and New Albany, Indiana. Baptist Health also operates two joint venture hospitals: the 410-bed Baptist Health Deaconess Madisonville in Madisonville, Kentucky with Deaconess Health System based in Evansville, Indiana, and the Baptist Health Rehabilitation Hospital, a 40-bed inpatient rehabilitation facility with Encompass Health, based in Birmingham, Alabama. Baptist Health employs more than 24,000 people in Kentucky and surrounding states. Baptist Health is the first health system in the U.S. to have all of its hospitals recognized by the American Nursing Credentialing Center with either a Magnet or Pathway to Excellence designation for nursing excellence. Baptist Health’s employed provider network, Baptist Health Medical Group, has more than 1,820 employed providers offering care in 78 specialties, including approximately 862 physicians and 958 advanced practice clinicians. Baptist Health’s physician network also includes more than 2,000 independent physicians.

Baptist Health specifically encourages minority, female, disabled, veteran and other candidates from diverse backgrounds to apply and strengthen our team.

Please note that Baptist Health is a drug-free workplace and employment with Baptist Health is subject to post offer, pre-employment drug testing.

NOTICE OF NONDISCRMISSION AND ACCESSIBILITY TO SERVICES Persons with hearing and speech impairments can contact Baptist Health facilities by using the Kentucky Relay Service, a toll‑free telecommunication device for the deaf (TDD). For voice to TDD, call 800.648.6057. For TDD to voice, call 800.648.6056.

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