Revenue Integrity Reimbursement Auditor

Revenue Integrity Reimbursement Auditor

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

Research denials and / or suspected payment variances from all commercial and governmental payors, including audits RACs or similar Medicare and Medicaid programs. Analyzes Negotiated Payor Contract Terms and Payment Appendices, Provider Manuals, and Provider Policies / Bulletins, and understands modeled expected reimbursement methodology as it applies to the services rendered to Baptist Health patients. Performs recovery efforts on reimbursement discrepancies monitoring the payor dispute / appeal, escalation to the Director / Manager, or Managed Care until resolution is achieved. Facilitates development of strategies after trends which negatively impact reimbursement are identified both at the corporate and / or facility level in order to improve reimbursement for Baptist Health System.

Minimum Education, Experience, Training and Licensures Required :

• Bachelor's degree
• Five years healthcare experience with 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 one of the revenue cycle related areas listed above.
• 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.

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.

EEO Statement : Baptist Health is an Equal Employment Opportunity employer, and seeks to employ individuals without regard to race, color, national origin, gender, sexual orientation, gender identity, age, disability, marital status, citizenship status, military status, religious or political beliefs, protected veteran status, employment status or any other protected class identified in any federal, state, or local law. Baptist Health specifically encourages minority, female, disabled, veteran and other candidates from diverse backgrounds to apply and strengthen our team. Please note that Baptist Health is a drug-free workplace and employment with Baptist Health is subject to post offer, pre-employment drug testing. NOTICE OF NONDISCRIMINATION AND ACCESSIBILITY TO SERVICES Persons with hearing and speech impairments can contact Baptist Health facilities by using the Kentucky Relay Service, a toll-free telecommunication device for the deaf (TDD). For voice to TDD, call 800.648.6057. For TDD to voice, call 800.648.6056.