Revenue Cycle Specialist

BHS • Kentucky - Work from Home, KY

2d • Remote

About The Position

Baptist Health is hiring a Revenue Cycle Specialist for a remote position. The employee must reside in Kentucky, Indiana, or Illinois. The role researches denials from commercial and governmental payors and reviews accounts for payor compliance to determine medical necessity before and after services and billing. The specialist obtains pre-determinations, prior authorizations, and retroactive authorizations when required by payors. The role responds to account reviews using appropriate efforts to secure reimbursement, recover outstanding revenue, and prevent future revenue loss while meeting applicable payor and government timelines. Recovery efforts may include written letters, email, websites, and telephone communication.

Requirements

• Bachelor's degree and a minimum of two years of healthcare experience.
• In lieu of a 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.
• Residency in Kentucky, Indiana, or Illinois.

Responsibilities

• Research denials from commercial and governmental payors.
• Review accounts for payor compliance and determine medical necessity of services before and after service and billing.
• Obtain pre-determinations, prior authorizations, and retroactive authorizations when required by payors.
• Respond to account reviews to secure reimbursement, recover outstanding revenue, and prevent future revenue loss.
• Meet applicable payor and government timelines.
• Conduct recovery efforts through written letters, email, websites, and telephone communication.

What This Job Offers

• Job Type: Full-time