Lead Revenue Integrity Specialist

Lead Revenue Integrity Specialist

Baptist Health is looking for a Lead Revenue Integrity Specialist to join our team in Louisville, KY. The Lead Revenue Integrity Specialist 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.

Requirements :

• Bachelor's degree
• 5 years previous experience, additional experience may be substituted for degree
• Minimum five years healthcare experience including two years in a revenue cycle related area such as registration, patient financial services, or managed care.
• 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 timelines.