Offer summary

Qualifications:

Bachelor's degree or five years of healthcare experience including two years in a revenue cycle related area., Minimum of two years healthcare experience required., CPC certification and/or coding experience preferred., Strong understanding of payor compliance and medical necessity..

Key responsabilities:

Research denials from all commercial and governmental payors.

Perform payor compliance reviews to determine medical necessity of services.

Obtain pre-determinations, prior authorizations, and retro authorizations as required.

Respond to account reviews to ensure reimbursement and recover outstanding revenue.

Founded in 1924 in Louisville, Kentucky, Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves. The Baptist Health family consists of nine hospitals, employed and independent physicians, and more than 400 points of care, including outpatient facilities, physician practices and services, urgent care clinics, outpatient diagnostic and surgery centers, home care, fitness centers, and occupational medicine and physical therapy clinics. Baptist Health’s eight owned hospitals include more than 2,300 licensed beds in Corbin, Elizabethtown, La Grange, Lexington, Louisville, Paducah, Richmond and New Albany, Indiana. Baptist Health also operates the 410-bed Baptist Health Deaconess Madisonville in Madisonville, Kentucky in a joint venture with Deaconess Health System based in Evansville, Indiana. Baptist Health employs more than 23,000 people in Kentucky and surrounding states. Baptist Health is the first health system in the U.S. to have all of its hospitals recognized by the American Nursing Credentialing Center with either a Magnet® or Pathway to Excellence® designation for nursing excellence. Baptist Health’s employed provider network, Baptist Health Medical Group, has nearly 1,500 providers, including more than 750 physicians and more than 740 advanced practice clinicians. Baptist Health’s physician network also includes more than 2,000 independent physicians. Learn more at BaptistHealth.com.

Job description

Job Description:

Baptist Health is looking for a Revenue Cycle Specialist to join our team.

This is a remote position that requires residency in KY or IN

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.

Minimum Education, Experience, Training and Licensures Required

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
CPC certification and/or coding experience preferred.