Revenue Integrity Reimbursement Auditor

Summary

Job Description:

Baptist Health is looking for a Revenue Integrity Reimbursement Auditor to join our team! This is a remote work position that requires residency in KY or IN

Research denials and/or suspected underpayments from all commercial and governmental payors, including pre-denial audits performed by UPICs or similar entities and analyzes fee schedules and modeled contracts in order to determine if Baptist Healthcare System received appropriate reimbursement.

Performs recovery efforts on reimbursement discrepancies and follows up until resolution. Facilitates development of strategies at the corporate and facility level to improve reimbursement after identifying trends that negatively impact reimbursement.

Qualifications:

• Bachelor's Degree in a related field with at least five years healthcare experience, two of which must be in a revenue cycle related area such as registration, patient accounting, financial services, or managed care. In lieu of bachelor's degree, eight years of healthcare experience required with at least five of those in a revenue cycle related area as listed above.

• Requires knowledge of medical terminology; payor reimbursement guidelines (authorization / notification, medical necessity, and timely filing guidelines); payor denial appeal / underpayment resolution processes; and managed care contracts. Individuals working with government audits must have a keen understanding of all audit response requirements and timelines.