Claims Resolution Manager, Hybrid, Metro Square

Baptist Health System, Inc. • Pelzer, SC

3d • Hybrid

About The Position

Baptist Health is looking to add a Claims Resolution Manager in our Hospital Billing Department at Baptist Metro Square. This is a Full Time and Hybrid opportunity. Baptist Jacksonville is a Magnet™ designated hospital, the gold standard for excellence in patient care. We serve families throughout the area with high-quality, comprehensive care for every stage of life.

Requirements

• 3-5 Years - Denials Management Experience (Required)
• 3-5 Years - Experience Hospital Claims Follow-Up Experience (Required)
• 3-5 Years - Leadership Experience (Required)
• 3-5 Years - Payer Strategy Experience (Required)
• 1-2 Years - Process Improvement Experience (Required)
• 5+ Years - Relevant equivalent experience in lieu of education (Required)
• 3-5 Years - Appeals Management Experience (Required)

Responsibilities

• Leads a team dedicated to physician billing claims follow up who can determine why a claim is underpaid or denied taking the necessary steps to resolve the claim to payment.
• The manager possesses critical thinking skills and the ability to implement processes that improve efficiencies, optimize team members strengths, and consider system abilities or limitations.
• There is a focus on quality claims resolution rather than claim touch or productivity and enhancing team members skillsets and intrinsic motivation to find a solution to claim payment.
• The manager has experience in both Managed Care and government payers and is capable of distinguishing internal process gaps versus payer related issues.
• Duties include strategic planning for staffing needs and cross training, workload distribution, and team member development such as mentorship, effective delegation, and open communication.
• The manager is driven to find solutions and confident in making decisions based on pertinent information and metrics.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager