Billing Specialist, Revenue Cycle, FT, 8A-4:30P

Baptist Health South Florida • Boca Raton, FL

4d

About The Position

Baptist Health is the largest not-for-profit healthcare organization in the region, operating 12 hospitals, over 28,000 employees, 4,500 physicians, and 200 outpatient centers across multiple counties in South Florida. The organization is recognized for its centers of excellence in various medical fields and has been named one of Fortune’s 100 Best Companies to Work For for 25 years. In the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida. The culture at Baptist Health emphasizes personal connections, meaningful relationships with patients and families, and a shared commitment to compassion and quality, driven by a faith-based mission of medical excellence. The Billing Specialist I is responsible for managing and editing daily downloads of Managed Care/HMO claims to ensure timely and accurate transmission. This role involves identifying and resolving invalid or missing claim data by communicating with other departments, protecting payer filing deadlines, and adhering to all regulatory, contractual, compliance, and BHSF guidelines. The specialist will also serve as a backup for billing all carriers, utilize system resources to resolve claim issues, report billing system problems to management, and assist other Billing Specialists with projects.

Requirements

• High School, Cert, GED, Trn, Exper.
• Managed Care/HMO contract billing experience
• 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
• 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
• Extensive analytical skills
• Critical thinking skills
• Detail oriented
• Problem solver
• Good mathematical skills
• Good writing skills
• Good interpersonal skills
• Ability 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

Nice To Haves

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

Responsibilities

• 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
• Being willing to take 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees