Revenue Integrity RN

Kentuckyonsite

Posted today · via Workday

About this role

Summary Job Description: Baptist Health is looking for a Revenue Integrity RN to join our team! This is a remote work position that requires residency in KY or IN Performs payor compliance review on accounts to determine medical necessity of services, pre and post service as well as pre and post billing. Obtains predeterminations / prior authorizations when required by payor. Reviews medical necessity denials from commercial and governmental payors, including pre-denial audits performed by RACs or similar Medicare and Medicaid programs. Responds to all denials or pre-denial audits with best possible efforts to recover outstanding revenue or prevent future revenue loss, meeting all appropriate payor or government timelines. Serves as clinical resource for other Revenue Integrity staff.…

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What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

1

Skills match

We compare your skills against the role requirements.

2

Level fit

We check your title trajectory against the seniority signal of the role.

3

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

4

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

5

Location fit

This role is based in Kentucky. We weight your proximity and willingness to relocate.

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