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Revenue Integrity Specialist

2 months ago

Lexington, Kentucky, United States Baptist Health Full time

Job Summary:

Baptist Health is seeking a highly skilled Revenue Integrity Specialist to join our team in a revenue cycle related area. The ideal candidate will have a strong background in medical terminology, payor reimbursement guidelines, and managed care contracts.

Key Responsibilities:

  • Research and analyze denials or audits from commercial and governmental payors to ensure accurate reimbursement.
  • Perform payor compliance reviews to determine medical necessity of services and obtain necessary authorizations.
  • Respond to account reviews in a timely manner to ensure reimbursement and prevent future revenue loss.
  • Collaborate with cross-functional teams to resolve issues and improve revenue cycle processes.

Requirements:

  • Bachelor's Degree in a related field, Practical Nurse License, or Coding Certification with at least two years of healthcare experience.
  • Strong knowledge of medical terminology, payor reimbursement guidelines, and managed care contracts.
  • Excellent analytical and communication skills.

About Baptist Health:

Baptist Health is a leading healthcare provider committed to delivering high-quality patient care and exceptional service. We are dedicated to fostering a culture of teamwork, innovation, and excellence.