Claims Resolution Specialist III, Hospital Billing, Baptist Metro Square

Baptist Health System, Inc. • Akron, OH

1d • Onsite

About The Position

Baptist Health is looking to add a Claims Resolution Specialist III to our Hospital Billing team at Baptist Metro Square. This is a Full-Time Days opportunity. The Claims Resolution Specialist III should have expertise in the following areas within the revenue Cycle: Registration, Eligibility, Charge Capture, Clearinghouse, Payment Posting, Claim Denial, and Credit Management.

Requirements

• Expertise in Registration, Eligibility, Charge Capture, Clearinghouse, Payment Posting, Claim Denial, and Credit Management within the revenue cycle.
• Up to date knowledge related to CPT codes, ICD/10 codes.

Responsibilities

• Appropriately resolving each medical claim sent to commercial insurance companies, third party organizations and/or government payers.
• Analyzing explanation of benefits to insure proper payment to Baptist Health from paying entities.
• Communicating with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
• Follow-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 claim to resolve denials.
• Possessing 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: No Education Listed