Revenue Cycle Specialist
2 weeks ago
About the Role:
Baptist Health is seeking a skilled Revenue Integrity Specialist I to join our team in Lexington, KY.
As a key member of our team, you will play a critical role in ensuring the accuracy and integrity of our revenue cycle processes.
Key Responsibilities:- Conduct thorough research and analysis of denials or audits from commercial and governmental payors to identify areas for improvement and optimize revenue cycle efficiency.
- Perform payor compliance reviews to determine medical necessity of services and ensure adherence to payor guidelines, promoting a culture of compliance within the organization.
- Obtain necessary authorizations, predeterminations, and prior authorizations from payors to ensure timely reimbursement and prevent revenue loss.
- Respond to account reviews to ensure accurate reimbursement, recover outstanding revenue, and prevent future revenue loss, fostering strong relationships with payors and stakeholders.
- Communicate effectively with payors and other stakeholders to resolve issues and ensure timely resolution, upholding the highest standards of professionalism and customer service.
- Bachelor's Degree in a related field, Practical Nurse License, or Coding Certification with at least two years of 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.
- Knowledge of medical terminology, payor reimbursement guidelines, and managed care contracts.
- Strong analytical and problem-solving skills, with ability to work in a fast-paced environment and adapt to changing priorities.
Baptist Health is a growing family of healthcare professionals dedicated to supporting clinical excellence, teamwork, and innovation. We are committed to providing high-quality patient care and improving the health of our communities.
Join Our Team:
If you are a motivated and detail-oriented individual with a passion for revenue integrity, we encourage you to submit your application.
We offer a dynamic and supportive work environment, with opportunities for growth and development.-
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