Revenue Integrity Reimbursement Auditor

Job not on LinkedIn

🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Baptist Health System KY & IN

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1924

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Baptist Health System KY & IN is a comprehensive healthcare provider operating in Kentucky and Southern Indiana. It offers a wide range of services such as behavioral health, cancer care, gastroenterology, heart care, imaging and diagnostics, and specialized care for mother and baby, neurology, stroke, orthopedics, and sports medicine. The system provides various types of care including emergency, urgent, and virtual care, and supports digital health through their MyChart app. Baptist Health is committed to community health through outreach programs, education, and research, and emphasizes patient safety and quality care across its numerous locations. It offers extensive career opportunities in healthcare and strives for transparency and patient-centered care.

📋 Description

• Research denials and suspected underpayments from commercial and governmental payors • Perform pre-denial audits by UPICs or similar entities • Analyze fee schedules and modeled contracts to determine whether Baptist Healthcare System received appropriate reimbursement • Perform recovery efforts on reimbursement discrepancies and follow up until resolution • Facilitate development of corporate- and facility-level strategies to improve reimbursement • Identify trends that negatively impact reimbursement

🎯 Requirements

• Bachelor’s Degree in a related field with at least five years of healthcare experience • At least two years of experience in a revenue cycle related area such as registration, patient accounting, financial services, or managed care • In lieu of a bachelor’s degree, eight years of healthcare experience required, with at least five years in a revenue cycle related area • Knowledge of medical terminology • Knowledge of payor reimbursement guidelines, including authorization/notification, medical necessity, and timely filing guidelines • Knowledge of payor denial appeal and underpayment resolution processes • Knowledge of managed care contracts • Keen understanding of audit response requirements and timelines for government audits • Residency in KY or IN • Must pass post-offer, pre-employment drug testing

🏖️ Benefits

• Remote work position • Equal Employment Opportunity employer • Drug-free workplace • Post-offer, pre-employment drug testing