Logo for Baptist Health System KY & IN

Revenue Integrity Reimbursement Auditor

Role overview

Qualifications

  • Bachelor’s Degree in a related field
  • At least five years healthcare experience
  • Two years in a revenue cycle related area
  • Knowledge of medical terminology and payor reimbursement guidelines

Responsibilities

  • Research denials and underpayments from all payors
  • Perform recovery efforts on reimbursement discrepancies
  • Facilitate development of strategies to improve reimbursement
  • Analyze fee schedules and modeled contracts

Key facts

Other skills

  • Teamwork
  • Communication

About the company

Baptist Health System KY & IN logo

Baptist Health System KY & IN

Hospitals & Health Care

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.

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size10001

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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.

If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!

Baptist Health is an Equal Employment Opportunity employer.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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