Claims Resolution Specialist I, Hospital Billing Office, Baptist Metro Square
2 weeks ago
Job Summary
Baptist Health is hiring a Claims Resolution Specialist I for our Hospital Billing Team department. This is a full-time days position located at Baptist Metro Square. The ideal candidate must have Claims Resolution experience working in a healthcare setting.
Shift Details: Monday-Friday 8:00am - 5:00pm.
Claims Resolution Specialist I, Hospital Billing Office, Job Responsibilities:
- Resolves each medical claim sent to commercial insurance companies, third party organizations and/or government payers.
- Analyzes explanation of benefits to insure proper payment to Baptist Health from paying entities.
- Communicates with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
- Follows-up daily on post processing activity including but not limited to, rejected billings, adjustments, corrected claims, overpayments, and denied claims.
- Works all assigned accounts on worklist in order depending on balance and age. Identify and communicate trends in denials to leadership.
- Requires experience in either HB or PB while working toward competency in all areas of the assigned vertical.
- Communicates with various departments to resolve any outstanding issues with claim to resolve denials.
- Possesses up to date knowledge related to CPT codes, ICD/10 codes.
If you are interested in this Claims Resolution Specialist I position at Baptist Metro Square, please apply now
StatusFull-Time
Shift DetailsDays
Education RequiredHigh School Diploma/GED
Education PreferredBachelor's Degree
License and Certification
- Certified Revenue Cycle Specialist (CRCS) Preferred Or
- Certified Revenue Cycle Representative (CRCR) Preferred Or
Experience
- 1-2 years Revenue Cylce Operations Experience Required
- Less than 1 year Billing Experience Required
- Less than 1 year Medical Insurance Experience Required
- Less than 1 year Reimbursement Experience Required
- Less than 1 year Accounts Receivable Experience Required
- Less than 1 year Knowledge of CPT, ICD10, HCPCS and Modifiers Required
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