Lead Revenue Integrity Specialist

Summary

Job Description:

Baptist Health is looking for a Lead Revenue Integrity Specialist to join their team in Lexington, KY

Supports the day-to-day operations within Payor Audits and/or Denials management for all payors. Workswith Director to lead the development, implementation and maintenance of standardized policies,procedures and strategies including workflow for Payor Audits and Denials Management functions withinBaptist Health. Serves as a system expert in Payor Audits and/or Denials Management.

Qualifications:

• Bachelor's Degree in a related field, Practical Nurse License, or Coding Certification 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.

• 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 / underpayment resolution processes; and managed care contracts. Individuals working with government audits must have a keen understanding of all audit response requirements and timelines.

Work Experience

Education