Baptist Health

Full-spectrum health system with hospitals

Revenue Cycle Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeMadisonville, KY, USANo salary listedIn-person

About the Job

Requirements

A bachelor's degree is required, or five years of healthcare experience including two years in a revenue cycle-related area such as registration, patient financial services, or managed care may be substituted.
Two years of job-related experience is required.

Responsibilities

Research denials from commercial and governmental payors.
Perform payor compliance reviews on accounts to determine medical necessity of services before and after service and before and after billing.
Obtain predeterminations, prior authorizations, and retro authorizations when required by the payor.
Respond to account reviews with the best possible efforts to ensure reimbursement, recover outstanding revenue, and prevent future revenue loss while meeting applicable payor or government timelines.
Pursue recovery through written letters, email, websites, and telephone communication.

Summary

Job Description:

Baptist Health is looking for a Revenue Cycle Specialist to join our team in Madisonville, KY

The Revenue Cycle Specialist will be responsible for researching 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.

Requirements

Bachelor's degree, in lieu of Bachelor’s degree, five years of healthcare experience required including two years in a revenue cycle related area such as registration, patient financial services, or managed care.
2 years job related experience

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!

Baptist Health is an Equal Employment Opportunity employer.

About the Company

Baptist Health

Full-spectrum health system with hospitals

Baptist Health is a regional health system with nine hospitals and more than 400 care sites across Kentucky and Indiana, offering inpatient services, outpatient clinics, home health, urgent care, diagnostic and surgery centers, and therapies. It combines employed physicians in Baptist Health Medical Group with a large network of independent clinicians to deliver comprehensive care across the continuum, including hospital care, primary care, specialty practices, and wellness services. Its hospitals hold Magnet or Pathway to Excellence nursing designations, reflecting a focus on nursing quality, and the system aims to provide accessible, high-quality health care to communities through a broad, integrated network. The goal is to improve community health by delivering coordinated, patient-centered care across a wide geographic footprint.

Company size: 1,001-5,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Little Rock, AR
Founded: 1924

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