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.

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 Require

• 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