Revenue Cycle Specialist

Baptist Health; Louisville (KY); Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking a Revenue Cycle Specialist to join their remote team. This role is crucial for researching denials from various payors and ensuring compliance with medical necessity standards. With a focus on recovering outstanding revenue and preventing future losses, the ideal candidate will possess strong healthcare experience and problem-solving skills. If you are passionate about supporting clinical excellence and teamwork, this opportunity is perfect for you.

Qualifications

• Bachelor's degree or five years of healthcare experience.
• Minimum of two years in a healthcare setting.

Responsibilities

• Research denials from all payors to ensure reimbursement.
• Perform compliance reviews to determine medical necessity.

Skills

Healthcare Experience

Revenue Cycle Management

Communication Skills

Problem-Solving Skills

Education

Bachelor's Degree

CPC Certification

Job description

Job Description:

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

This is a remote position that requires residency in KY or IN

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.

Minimum Education, Experience, Training and Licensures Required

• 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

• CPC certification and/or coding experience preferred.

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! Baptist Health is an Equal Employment Opportunity employer.