[Hiring] Claims Resolution Specialist I @Baptist Health System, Inc.

Role Description

Baptist Metro Square currently hiring for a Full-Time Claims Resolution Specialist I to join our team here in Jacksonville.

As a Claims Resolution Specialist I, you will be responsible for:

• Appropriately resolving each medical claim sent to commercial insurance companies, third party organizations and/or government payers.
• Having experience and demonstrated competency in at least 2 of the following areas within the revenue Cycle: Registration, Eligibility, Charge Capture, Clearinghouse, Payment Posting, Claim Denial, and Credit Management.
• Analyzing explanation of benefits to ensure proper payment to Baptist Health from paying entities.
• Communicating with third-party representatives as necessary to complete claims processing and/or resolve problem claims.
• Following up daily on post processing activity including but not limited to, rejected billings, adjustments, corrected claims, overpayments, and denied claims.
• Working all assigned accounts on worklist in order depending on balance and age.
• Identifying and communicating trends in denials to leadership.
• Communicating with various departments to resolve any outstanding issues with claims to resolve denials.
• Possessing up-to-date knowledge related to CPT codes, ICD/10 codes.

Qualifications

• 1-2 years Customer Service Experience Required
• 1-2 years Healthcare experience required
• 1-2 years Insurance experience required

Requirements

• High School Diploma Required

Company Description

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.