Revenue Cycle Specialist

Kyeatright; Kentucky; Remote; USD 55,000 - 75,000; 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 offers the chance to work across commercial and governmental payors to research denials and ensure reimbursement.

You will perform payor compliance reviews, determine medical necessity, obtain pre-determinations and authorizations, and respond promptly to reviews to recover revenue while meeting deadlines. Prior revenue cycle experience is preferred.

Qualifications

• Bachelor's degree required or equivalent healthcare experience.
• Minimum two years of healthcare experience; if no degree, five years in healthcare including two years in revenue cycle.
• Experience in revenue cycle areas such as registration, patient financial services, or managed care preferred.

Responsibilities

• Research denials from all commercial and governmental payors.
• Conduct payor compliance reviews to determine medical necessity for services pre/post delivery and pre/post billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when payor requires.
• Respond to account reviews with best efforts to ensure reimbursement and recover revenue while meeting payor/government timelines.
• Recovery efforts include written letters, emails, web interactions, and phone communications.

Skills

Payor knowledge

Denials research

Communication skills

Education

Bachelor's degree

Job description

## Revenue Cycle SpecialistApply: Kentucky: Full time: Posted Today: R26108523**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.### *If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!*