[Hiring] Revenue Integrity Specialist I @BHS

Role Description

Baptist Health is looking for a Revenue Integrity Specialist I to join our team! This is a remote position that requires residency in KY or IN.

• Research denials or audits from all commercial and governmental payors.
• Perform payor compliance review on accounts to determine medical necessity of services, pre and post service as well as pre and post billing.
• Obtain predeterminations, prior authorizations, and retro authorizations when required by payor.
• Respond 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 letters, email, web site, and telephonic communication.

Qualifications

• Bachelor’s Degree in a related field, Practical Nurse License, or Coding Certification with at least two years healthcare experience.
• In lieu of bachelor’s degree, five years of healthcare experience required with at least two of those in a revenue cycle related area such as registration, patient accounting, financial services, or managed care.
• Requires knowledge of medical terminology; payor reimbursement guidelines (authorization/notification, medical necessity, and timely filing guidelines); payor denial appeal resolution processes; and managed care contracts.
• Individuals working with government audits must have a keen understanding of all audit response requirements and timelines.

Benefits

• 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!

Company Description

Baptist Health is an Equal Employment Opportunity employer.