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

Baptist Health System, Inc. • Akron, OH

4d • Onsite

About The Position

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.

Requirements

• Claims Resolution experience working in a healthcare setting.
• Experience in either HB or PB while working toward competency in all areas of the assigned vertical.
• Up to date knowledge related to CPT codes, ICD/10 codes.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED