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The Revenue Cycle Specialist researches and resolves denials from commercial and governmental payors to ensure proper reimbursement. They also perform compliance reviews and manage pre-determinations and prior authorizations to prevent revenue loss.
Summary
Job Description:
Baptist Health is looking for a Revenue Cycle Specialist to join our team!
This is a remote work position that requires residency in KY, IN, IL.
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.
Qualifications:
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