Revenue Cycle Specialist

bhs; Kentucky; Remote; USD 42,000 - 70,000; Full time

Job summary

Baptist Health is seeking a Remote Revenue Cycle Specialist to join our team, supporting KY, IN, and IL residents. The role focuses on researching denials, ensuring medical necessity, and securing prior authorizations to maximize reimbursement. Must have healthcare experience and a related revenue cycle background.

The position offers remote work with residency requirements in Kentucky, Indiana, or Illinois, and requires strong communication to recover revenue and meet payer 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 related area such as registration, patient financial services, or managed care.

Responsibilities

• Research denials from all commercial and governmental payors.
• Perform payor compliance review on accounts to determine medical necessity of services, pre and post service as well as pre and post billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond 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.

Education

Bachelor's degree

Five years healthcare experience including two years in revenue cycle

Two years healthcare experience

Job description

Summary

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.