Revenue Cycle Specialist

BHS; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to join our team in a remote capacity, serving our patients across the United States while requiring residency in KY, IN or IL.

The role includes researching denials from all payors, performing payor compliance reviews to determine medical necessity, and obtaining pre-determinations and authorizations to maximize reimbursement while meeting timelines.

Equal opportunity employer and committed to outstanding patient financial services.

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

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

Skills

Healthcare experience

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.