Billing Specialist, Revenue Cycle, FT Job at Baptist Health (Boca Raton)

Job Description

Responsible for working/editing daily download of assigned Managed Care/HOM claims, optimizing the timely transmittal of accurate and clean claims daily Billing Specialist I is responsible for identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission Protects payer filing deadlines by utilizing all available resources to resolve held claims assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to. Must be willing to take on additional queues as back up to billing all carriers. Utilizes available system resources to resolve claim issues when appropriate reports any billing system issues to Billing management assists other Billing Specialists with claim resolution or other projects as assigned. Estimated pay range for this position is $16.04 - $19.41 / hour depending on experience.

Job Responsibility

Working/editing daily download of assigned Managed Care/HOM claims
Optimizing the timely transmittal of accurate and clean claims daily
Identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission
Protecting payer filing deadlines by utilizing all available resources to resolve held claims
Assuring all known regulatory, contractual, compliance, and BHSF guidelines are adhered to
Taking on additional queues as back up to billing all carriers
Utilizing available system resources to resolve claim issues when appropriate
Reporting any billing system issues to Billing management
Assisting other Billing Specialists with claim resolution or other projects as assigned

Requirements

Degrees: High School,Cert,GED,Trn,Exper.
AA preferred or equivalent
Managed Care/HMO contract billing experience required
3-5 years prior experience in Billing of claims
Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required
Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus
Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus
Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE)
Internet savvy
knowledge of Microsoft Suite a must
Extensive analytical
critical thinking
detail oriented
problem solver
good mathematical, writing, and interpersonal skills required
Must be able to communicate effectively with other depts. in order to resolve pending/missing information on claims to expedite the timely transmission to payers
Excellent Time-Management skills
Ability to multi-task and work under pressure in order to meet stringent deadlines
Minimum Required Experience: 3 Years

Nice to have

Background in coding or coding certification (CPC, CPC-H, CCS, or RMC)
Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims

What we offer

Career growth and development opportunities
Comprehensive health and wellness resources
Wellness program that can help employees eliminate their medical plan deductible
Tuition reimbursement

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Billing Specialist, Revenue Cycle, FT

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