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Medical Reimbursement Expert
2 months ago
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 and recovery efforts to ensure timely reimbursement and prevent future revenue loss.
- Collaborate with cross-functional teams to resolve complex reimbursement issues.
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.
