Claims Processor, Medical Billing

3 weeks ago


Gainesville, United States UF Health Shands Hospital Full time

**Job Opening Summary**:
Researches and reviews claims for accuracy and to ensure payer-specific guidelines are met for correct billing to third-party payers. Makes payer calls and/or utilizes payer portals/resources systems to pursue payment of third-party claims. Make appropriate determination for contractual adjustments, verifies system balances and calculates and post adjustments. Ensures financial integrity of Shands HealthCare by processing and expediting billing and collection processes.

**Job Opening Qualifications**:
**Minimum Education and Experience Requirements**:

- Minimum high school graduate or equivalent. Prefer some college-level business, finance or accounting courses.
- Requires six months of billing/collection experience in a hospital and/or physician's office or a minimum of one year of experience in business setting dealing with finance, accounting, insurance portal systems.
- Experience in Blue Cross, Medicare, Medicaid and/or other third-party payer billing or collections preferred.
- College education may be substituted for experience.
- Must have above-average math skills and be proficient on a calculator.
- Must be able to demonstrate the ability to communicate well with others and work independently under pressure and consistently achieve desired results.
- Must be able to deal effectively with the public and be able to use good judgment in the pursuit of resolving accounts.
- Knowledge of medical terminology preferred.
- Prefer experience with computerized insurance billing system and Microsoft programs.

**Shift hours**:8 a.m. - 5 p.m., Monday-Friday



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