Claims Resolution Specialist II, Hospital Billing Office, Baptist Metro Square

Claims Resolution Specialist II, Hospital Billing Office, Baptist Metro Square Baptist Health System, Inc. Jacksonville, FL Job Details Full-time 16 hours ago Qualifications High school diploma or GED Full Job Description About Baptist Health Recognized as a top place to work in health care, Baptist Health cares for more patients in Northeast Florida than any other provider, ranking as "most preferred" for more than 30 years. We're Jacksonville's only locally governed, faith-based, not-for-profit health system and provide a full spectrum of preventive and specialty care through 200+ locations and six hospitals. Our centers of excellence include Baptist MD Anderson Cancer Center, Baptist Heart Hospital, Baptist Neurological Institute and Wolfson Children's Hospital. Baptist Health is hiring a Claims Resolution Specialist II 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.

Claims Resolution Specialist II, 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.

Education & Credential Requirements:

High school diploma (or higher) Required If you are interested in this Claims Resolution Specialist II position at Baptist Metro Square, please apply now!

Primary Location:

Metro Square