Telecommute Healthcare Reimbursement Specialist

BHS; Springfield (IL); Remote; USD 65,000 - 75,000; Full time

Job summary

Baptist Health is seeking a Revenue Cycle Specialist to support the denial management and reimbursement process. This is a remote position with residency requirements in KY, IN, or IL.

The role focuses on researching denials, ensuring medical necessity, and obtaining authorizations to improve cash flow. Collaboration with care teams and payors is essential to reduce denials and accelerate payments.

Qualifications

• Bachelor’s degree or five years of healthcare revenue cycle experience.
• Experience with registration, patient financial services, or managed care preferred.
• Proficiency in analyzing denials and payor timelines.

Responsibilities

• Research denials from all commercial and governmental payors.
• Perform payor compliance review to determine medical necessity.
• Obtain pre-determinations and prior authorizations when required.
• Respond to reviews to maximize reimbursement and minimize losses.
• Communicate via letters, email, and phone to recover revenue.

Skills

Healthcare experience

Revenue cycle

Denials management

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. If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation,

Qualifications

Qualifications:Bachelor's degreeMinimum 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.