[Hiring] Revenue Integrity Reimbursement Auditor @BHS

Role 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.
• Analyze fee schedules and modeled contracts to determine if Baptist Healthcare System received appropriate reimbursement.
• Perform recovery efforts on reimbursement discrepancies and follow up until resolution.
• Facilitate 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.

Company Description

Baptist Health is an Equal Employment Opportunity employer.