Summary
Job Description:
Baptist Health is looking for a Lead Revenue Integrity Specialist to join their team. This is a remote work position that requires residency in KY or IN
Supports the day-to-day operations within Payor Audits and/or Denials Management for all payors. Works with Director to lead the development, implementation and maintenance of standardized policies, procedures and strategies including workflow for Payor Audits and Denials Management functions within
Baptist Health. Serves as a system expert in Payor Audits and/or Denials Management.
Qualifications:
Bachelor’s Degree in related field, Practical Nurse License, or Coding Certification with five years healthcare experience including two years in a revenue cycle related area such as registration, patient financial services, or managed care.
In lieu of Bachelor’s degree, eight years of healthcare experience required including five years in a revenue cycle related area as listed above.
One year of team lead or supervisory experience preferred.
Requires knowledge of medical terminology; payor reimbursement guidelines (authorization / notification, medical necessity, and timely filing guidelines); payor denial appeal / payment variance resolution processes; and managed care contracts. Individuals working with payor audits must have a keen understanding of all audit response requirements and timeline.
Work Experience
Education