Revenue Cycle Specialist

Baptist Health; Louisville (KY); Remote; USD 55,000 - 75,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to join our team. This is a remote work position that requires residency in KY, IN, IL.

The role involves researching denials from all payors, performing payor compliance reviews, and obtaining pre-determinations and authorizations as required. You will respond to reviews and work to recover revenue while meeting timelines across payors.

Qualifications

• Bachelor's degree or equivalent healthcare experience.
• Minimum of two years healthcare experience.
• In lieu of Bachelor's degree, five years healthcare experience including two years in revenue cycle related area such as registration, patient financial services, or managed care.

Responsibilities

• Research denials from commercial and governmental payors and perform payor compliance review to determine medical necessity and pre/post service as well as pre/post billing.
• Obtain pre-determinations, prior authorizations, and retro authorizations when required by payor.
• Respond to account reviews and pursue recovery of revenue while meeting payor/government timelines.

Skills

Healthcare revenue cycle knowledge

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.