Revenue Integrity Reimbursement Auditor

Baptist Health; Louisville (KY); On-site; USD 65,000 - 90,000; Full time

Job summary

Baptist Health is seeking a Revenue Integrity Reimbursement Auditor to join our team. This remote position requires residency in KY or IN.

You will research denials and underpayments across payors, analyze fee schedules and modeled contracts to ensure proper reimbursement for Baptist Health. You will also perform recovery efforts on discrepancies and help develop strategies to improve reimbursement by identifying trends across corporate and facility levels.

Qualifications

• Bachelor's Degree in a related field with at least five years healthcare experience, two of which must be in a revenue cycle area.
• Knowledge of medical terminology; payor reimbursement guidelines; denial appeal and underpayment resolution processes.

Responsibilities

• Research denials and suspected underpayments from commercial and governmental payors.
• Perform recovery efforts on reimbursement discrepancies and follow up until resolution.
• Develop strategies at corporate and facility level to improve reimbursement after identifying trends.

Skills

Revenue cycle knowledge

Analytical skills

Education

Bachelor's Degree in a related field

Eight years of healthcare experience with 5 in revenue cycle

Job description

Summary

Job Description:

Baptist Health is looking for a Revenue Integrity Reimbursement Auditor to join our team! This is a remote work position that requires residency in KY or IN

Research denials and/or suspected underpayments from all commercial and governmental payors, including pre-denial audits performed by UPICs or similar entities and analyzes fee schedules and modeled contracts in order to determine if Baptist Healthcare System received appropriate reimbursement.

Performs recovery efforts on reimbursement discrepancies and follows up until resolution. Facilitates development of strategies at the corporate and facility level to improve reimbursement after identifying trends that negatively impact reimbursement.

Qualifications:

• Bachelor's Degree in a related field with at least five years healthcare experience, two of which must be in a revenue cycle related area such as registration, patient accounting, financial services, or managed care. In lieu of bachelor's degree, eight years of healthcare experience required with at least five of those in a revenue cycle related area as listed above.

• Requires knowledge of medical terminology; payor reimbursement guidelines (authorization / notification, medical necessity, and timely filing guidelines); payor denial appeal / underpayment resolution processes; and managed care contracts. Individuals working with government audits must have a keen understanding of all audit response requirements and timelines.

Baptist Health is an Equal Employment Opportunity employer.